Manuelle Medizin

, Volume 46, Issue 1, pp 23–26 | Cite as

Anatomie, Physiologie und Pathophysiologie der Bandscheiben – eine Literaturübersicht

Teil I: Anatomie und Physiologie der Bandscheiben
Originalien
First Online:

Zusammenfassung

Um die Degeneration von Bandscheiben verstehen zu können, sind Kenntnisse der Physiologie und Anatomie gesunder Bandscheiben notwendig. Im vorliegenden Teil I wird der aktuelle Wissensstand zur Anatomie, Biochemie und Physiologie von Bandscheiben dargestellt, im Teil II wird auf die Grundlagen der Bandscheibendegeneration eingegangen. Bandscheiben altern schneller als fast jedes andere Gewebe, da ihre Ernährung aufgrund der avaskulären Umgebung behindert ist. Die wichtigsten strukturellen Veränderungen im Degenerationsprozess stellen die Abnahme des Wassergehalts und des osmotischem Drucks dar, v. a. im Nucleus pulposus und im inneren Teil des Anulus fibrosus, sowie die Abnutzung der Matrix. Der abnehmende osmotische Druck verstärkt die Öffnung existierender Risse trotz der Abnahme der Scherkräfte im Anulus. Fibröse Veränderungen des Nukleus, Desorganisation des Anulus und Veränderungen des Wirbelkörpers und der Endplatten finden v. a. in den ersten beiden und in der 5.–7. Dekade statt. Sie sind in den unteren Bandscheiben stärker ausgeprägt als in den oberen und gehen der Formierung von Rissen und Spalten voraus. Der zeitliche Ablauf weist auf eine strenge Korrelation von Spalt- und Rissbildungen hin, die in der ersten Dekade im Nukleus beginnen. Randläsionen dagegen entstehen unabhängig und deutlich später.

Schlüsselwörter

Bandscheibendegeneration Wassergehalt Osmotischer Druck Nucleus pulposus Anulus fibrosus 

Anatomy, physiology and pathophysiology of intervertebral discs – a review of the literature

Part I: Anatomy and physiology of intervertebral discs

Abstract

In order to understand the degeneration of intervertebral discs, it is necessary to have knowledge on the physiology and anatomy of healthy intervertebral discs. In part I the current state of knowledge on the anatomy, biochemistry and physiology of intervertebral discs will be presented and part II will deal with the fundamentals of the degeneration of intervertebral discs. Intervertebral discs age faster than nearly all other tissues because the nutrient supply is impeded due to the lack of vascularisation. The most important structural alterations in the degenerative process are decreases in water content and osmotic pressure, especially in the nucleus pulposus, the inner part of the annulus fibrosus, as well as wear of the matrix. The decreasing osmotic pressure strengthens the opening of existing tears despite a decrease in shearing forces in the annulus. Fibrous alterations of the nucleus, breakdown in structure of the annulus and alterations to the vertebral bodies and the end plates occur most commonly in the first two and in the fifth to seventh decades of life. The alterations are more severe in the lower than in the upper vertebral discs and precede the formation of fissures and tears. The time scale shows a strong correlation with fissures and tears which appear in the first decade of life. In contrast edge lesions arise independently from them and appear much later.

Keywords

Intervertebral disc degeneration Water content Osmotic pressure Nucleus pulposus Anulus fibrosus 
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Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

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Copyright information

© Springer Medizin Verlag 2008

Authors and Affiliations

  1. 1.Gesundheitszentrum am Olympiastützpunkt PotsdamPotsdamDeutschland

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