J Anat December 2012 PMID 22881295

Intervertebral disc degeneration: evidence for two distinct phenotypes.

Michael A Adams, Patricia Dolan

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Abstract in brief

The article discusses two distinct types of intervertebral disc degeneration: endplate-driven, which is mostly inherited, affects upper lumbar and thoracic discs, and usually begins before age 30, often leading to moderate back pain; and annulus-driven, which has low heritability, affects lower lumbar discs, develops after age 30, and often results in severe pain and sciatica.
Endplate-driven degeneration involves defects in the endplates and inward collapse of the annulus, often from injury, while annulus-driven degeneration involves radial fissures and prolapse, typically related to repetitive movements and aging.
Both degeneration types involve structural changes that decompress the disc nucleus and tend to be mutually exclusive, representing two different pathways of disc deterioration.]

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