Bone & joints
Other nonneoplastic
Disc material
Author: Vijay Shankar, M.D.
Last author update: 1 January 2013
Last staff update: 7 January 2022
Copyright: 2002-2024, PathologyOutlines.com, Inc.
PubMed Search: Disc material joints [title]
Table of Contents
Definition / general | Case reports | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Shankar V. Disc material. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/jointsdiscmaterial.html. Accessed April 19th, 2024.
Definition / general
- Normal intervertebral disc contains central nucleus pulposus (water, proteoglycans) within an annulus of obliquely oriented collagen fibers and a cartilaginous end plate
- Elderly have shrunken, yellowed and dehydrated nucleus pulposus
- Common surgical specimen, obtained after intervertebral disc prolapse or herniation, which is most common in ages 20 - 39 years
- Anterior herniation usually is asymptomatic; posterior herniation puts pressure on nerve roots or spinal canal and produces symptoms
- Posterior herniation present in 50% of older individuals at autopsy, usually in lumbar spine
- Herniation refers to either prolapse, protrusion or extrusion
- Protrusion:
- Bulging of nucleus pulposus through weakened annulus fibrosus, usually posterior or posteriolateral
- Can rarely disappear spontaneously
- Prolapse:
- Rupture of nucleus pulposus through annulus but not the posterior or anterior longitudinal ligament
- Associated with neovascularization at edges of fibrocartilaginous fragments (Hum Pathol 1988;19:406)
- Usually in lumbar region
- May occur in thoracic or cervical disc
- Extrusion: rupture of nucleus pulposus through annulus and posterior or anterior longitudinal ligament
- Sequestration:
- Fragmentation of extruded segment, may extend into spinal canal or far from site of rupture
- Clinical symptoms depend on severity of herniation and position of offending disc
- Patient may develop cauda equina syndrome in severe cases
Case reports
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Protrusion:
- 45 year old woman with low back ache and sciatica (Br J Gen Pract 2008;58:646)
- 52 year old woman with abdominal pain (Ann R Coll Surg Engl 2009;91:W4)
- 60 year old man with brucellosis masquerading as spondylodiscitis with multiple intervertebral disc prolapse (J Glob Infect Dis 2012;4:184)
- 53 year old woman with spontaneous regression of large lumbar disc extrusion (J Korean Neurosurg Soc 2010;48:285)
- 68 year old man with extrusion of C7-D1 intervertebral disc associated with intradiscal hematoma (Turk Neurosurg 2011;21:446)
- 49 year old man with sequestered L5-S1 disc (Cox® Technic Case Report #63 sent August 2008 (pdf))
Prolapse:
Extrusion:
Sequestration:
Microscopic (histologic) description
- Annular fibrosus: collagen (pink)
- Nucleus pulposus: pure cartilage (blue)
- Herniated disk: vascular ingrowth
- Also chondrocyte proliferation, structural alterations in form of tears and clefts, granular changes and mucous degeneration (BMC Res Notes 2011;4:497)
Microscopic (histologic) images
Images hosted on other servers:
Intervertebral disc
Disc degeneration
