Histological analysis of vertebral disc herniations in patients with different age groups

Volodymyr Radchenko, Valentyn Piontkovsky, Ninel Dedukh


Studying of degenerative changes in the structure of vertebral discs and peculiarities of microscopic organization in patients with different age groups gives us possibility to connect pathomorphological changes with clinical symptoms.

Objective: to study the peculiarities of herniations structure which were obtained after surgeries in patients of different age groups.

Methods: herniations of vertebral discs on the levels LIII–LIV, LIV–LV и LV–SI were obtained after surgeries of 4 3 patients (24 women, 19 men) of three age groups: the 1st — 25–44 y. o, the 2nd — 45– 60, the 3rd — 61–75. We used histology with semiquantitative estimation (score) of degenerative changes.

Results: it was shown that the sex has not influence on the severity of degenerative changes of herniations. According to some histological signs we concluded distinctive features. It was found that in the 1st group in the samples there were mostly chondrons which contained more than 15 chondrocytes with large cores, it testifies of proliferation and hypertrophy. Severe destructive lesions of matrix were not found. With aging degenerative changes in herniations are progressed. So the number of large chordons was in 1.7 and 1.4 times lower in the 2nd group compare to the 1st one. Fibroblasts accumulation increased in the matrix (in 3 and 3.2 times in men and women), small foci of granular destruction and chondrogenesis appeared, areas with increased dense of fibroblasts, small bone sequestrations (21.4 %). In the 3rd group in men and women the number of chondrons in herniations were decreased in 2.6 and 2.3 times compare to the 1st group. Areas of defibration in the matrix became wider in 2.4 and 2 times, granular destruction — in 1.3 and 1.4 times. Large areas were with chondrogenesis and in 78.6 % of cases we have found small bone fragments.

Conclusion: with aging the severity of destructive changes in herniations increase significantly.


herniation of vertebral disc; structure; age changes


Deyo, R. A., & Mirza, S. K. (2016). Herniated lumbar intervertebral disk. New England Journal of Medicine, 374, 1763–1772. doi:10.1056/NEJMcp1512658

Radchenko, V., Piontkovsky, V., Kosterin, S., & Dedukh, N. (2018). Intervertebral disc: regeneration, herniation formation stages and molecular profile (literature review). Orthopaedics, traumatology and prosthetics, 4, 99–106. doi:10.15674/0030-59872017499-106 (in Russian)

Postacchini, F., & Postacchini, R. (2011). Operative management of lumbar disc herniation: the evolution of knowledge and surgical techniques in the last century. Acta neurochirurgica's Supplement, 108, 17–21. doi:10.1007/978-3-211-99370-5_4

Pouriesa, M., Fouladi, R. F., & Mesbahi, S. (2013). Disproportion of end plates and the lumbar intervertebral disc herniation. The Spine Journal, 13(4), 402-407. doi:10.1016/j.spinee.2012.11.047

Cai, Z., Ma, D., Li, F., Chen, R., Liu, Z., Zhang, Z., … Lu, X. (2013). Trend of the incidence of lumbar disc herniation: decreasing with aging in the elderly. Clinical Interventions in Aging, 1047. doi:10.2147/cia.s49698

Nilsson, E., Brisby, H., Rask, K., & Hammar, I. (2013). Mechanical compression and nucleus pulposus application on dorsal root ganglia differentially modify evoked neuronal activity in the thalamus. BioResearch Open Access, 2(3), 192-198. doi:10.1089/biores.2012.0281

Adams, M. A., & Dolan, P. (2016). Lumbar intervertebral disk injury, herniation and degeneration. Advanced Concepts in Lumbar Degenerative Disk Disease, 23-39. doi:10.1007/978-3-662-47756-4_3

Baptista, J. D., Fontes, R. B., & Liberti, E. A. (2015). Aging and degeneration of the intervertebral disc: review of basic science. Coluna/Columna, 14(2), 144-148. doi:10.1590/s1808-185120151402141963

Kotwal, S., Mohan, H., Bahadur, R., & Bal, A. (2002). A clinicopathological study of changes in intervertebral discs. The Internet Journal of Pathology, 2(2), 1–6.

Lama, P., Zehra, U., Balkovec, C., Claireaux, H. A., Flower, L., Harding, I. J., … Adams, M. A. (2014). Significance of cartilage endplate within herniated disc tissue. European Spine Journal, 23(9), 1869-1877. doi:10.1007/s00586-014-3399-3

Oprea, M., Popa, I., Cimpean, A. M., Raica, M., & Poenaru, D. V. (2015). Microscopic assessment of degenerated intervertebral disc: clinical implications and possible therapeutic challenge. Іn vivo, 29(1), 95–102.

ST/ESA/STAT/SER.M/74. Рrovisional guidelines on standard international age classifications. (1982). New York.

Sarkisov, D. S., & Perov, Yu. L. (1996). Microscopic technology. Moscow: Medicine. (in Russian)

Boos, N., Weissbach, S., Rohrbach, H., Weiler, C., Spratt, K. F., & Nerlich, A. G. (2002). Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine, 27 (23), 2631-2644. doi:10.1097/01.BRS.0000035304.27153.5B

Weiler, C., Lopez-Ramos, M., Mayer, H., Korge, A., Siepe, C. J., Wuertz, K., … Nerlich, A. G. (2011). Histological analysis of surgical lumbar intervertebral disc tissue provides evidence for an association between disc degeneration and increased body mass index. BMC Research Notes, 4(1), 497. doi:10.1186/1756-0500-4-497

Lama, P., Le Maitre, C. L., Dolan, P., Tarlton, J. F., Harding, I. J., & Adams, M. A. (2013). Do intervertebral discs degenerate before they herniate, or after? The Bone & Joint Journal, 95-B(8), 1127-1133. doi:10.1302/0301-620x.95b8.31660

Hamdan, T. A., & Jbara, K. K. (2006). Histological and structural study of prolapsed intervertebral disc. Basrah Journal of Surgery.

Dedukh, N. V. (2010). Vertebral column. Guide to histology (2 nd ed.) (pp. 301-306). In R.K. Danilov (Ed.). St Petersburg: Spec-Lit. (in Russian)

Dowdell, J., Erwin, M., … Choma, T. (2017). Intervertebral disc degeneration and reparation. Neurosurgery, 80(3S), S46–S54. doi:10.1093/neuros/nyw078

Roberts, S. (2002). Disc morphology in health and disease. Biochemical Society Transactions, 30(6), 864-869. doi:10.1042/bst0300864

Johnson, W. E., Caterson, B., Eisenstein, S. M., Hynds, D. L., Snow, D. M., & Roberts, S. (2002). Human intervertebral disc aggrecan inhibits nerve growth in vitro. Arthritis & Rheumatism, 46(10), 2658-2664. doi:10.1002/art.10585

Repanti, M., Korovessis, P. G., Stamatakis, M. V., Spastris, P., & Kosti, P. (1998). Evolution of disc degeneration in lumbar spine. Journal of Spinal Disorders, 11(1), 41–45. doi:10.1097/00002517-199802000-00007

Rajasekaran, S., Bajaj, N., Tubaki, V., Kanna, R. M., & Shetty, A. P. (2013). ISSLS Prize Winner. Spine, 38(17), 1491-1500. doi:10.1097/brs.0b013e31829a6fa6

Willburger, R. E., Ehiosun, U. K., Kuhnen, C., Krämer, J., & Schmid, G. (2004). Clinical symptoms in lumbar disc herniations and their correlation to the histological composition of the extruded disc material. Spine, 29(15), 1655-1661. doi:10.1097/01.brs.0000133645.94159.64

Copyright (c) 2018 Volodymyr Radchenko, Valentyn Piontkovsky, Ninel Dedukh

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.