A new study questions long-held beliefs about one of the most common causes of back pain, lumbar disc herniation.
The findings could have major treatment implications by modifying the conventional understanding of how lumbar disc herniation occurs.
In the study, researchers found that most cases of lumbar disc herniation are not caused by ruptured discs as previously thought, but by avulsion (separation) of the connective tissue between the spinal bone and disc in a process known as end plate junction (EPJ) failure.
"Our study shows that the incidence of EPJ failure has been grossly underrated, probably because of the difficulty of documentation," the researchers wrote.
A herniated disc, frequently called a "slipped" disc, occurs when the soft inside of a spinal disc protrudes outside of the tougher exterior due to aging, injury, or degenerative disc disease. In cases of injury, scientists believed the primary mechanism of disc herniation took place when the disc itself ruptured, allowing the soft center to leak out.
To test that theory, researchers publishing in the journal Spine studied 181 patients receiving surgery for herniated discs.
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