DEGENERATIVE INTERVERTEBRAL DISC DISEASE: DIFFICULTIES IN DEFINITION OF THE CONCEPT AND EPIDEMIOLOGY OF THE PHENOMENON. BRIEF COMMUNICATION

Abstract

The aim. The significant prevalence of intervertebral discs chronic pathology in the human population against the background of the lack of a clear and unified definition of the concept of «degenerative [intervertebral] disc disease» (DDD) creates difficulties in the study and formation of treatment protocols for this pathology. This study aims to clarify the epidemiological characteristics and terminological features of the pathology of the intervertebral discs covered by the term «DDD». Materials and methods. A systematic search in pubmed and related scientific and professional databases for publications devoted to DDD’s terminological features and epidemiology was conducted. In the analysis, the papers in which DDD and semantically related concepts and clinical phenomena are included as the primary research objects. Results. Based on the analysis, it is found that there is no unified defining the concept of DDD, which includes both initial degenerative changes in the disc, regardless of the manifestation of the pain syndrome, and conditions with a clear pathomorphological picture, such as intervertebral disc herniation, degenerative spinal stenosis, etc. DDD is pathophysiological and conventional; its list of pathomorphological and clinical correlates still needs to be completed. Clinical phenomena, considered the most certain correlates of DDD, can be caused by other pathological processes. Currently, the only but somewhat inaccurate indicator of the prevalence of back pain in the human population is the epidemiological characteristic of back pain, which, according to available calculations, can reach 800 million people at any given time, i.e., 10 % of the human population. Uncertainty regarding the semantics of the term DDD makes it challenging to unify research results and develop effective clinical protocols. Conclusions. The meaning of the term DDD remains unclear and non-unified, and the epidemiological characteristics of the phenomenon of back pain can only be used with significant caution for a rough estimate of the prevalence of clinically significant forms of ddd. Unifying and clarifying terminology, prevalence, and identification of benchmark etiological factors of DDD will allow to improve treatment protocols for this pathology and improve its results.

Keywords

• degenerative disc disease
• discogenic radiculopathy
• intervertebral disc herniation
• back pain
• epidemiology
• terminology