Wang ZP, Zhang HW, Zhao XY, Li YZ, Zhang XG, Zhao R, Qin DP. Intervertebral disc degeneration and aging: Shared molecular mechanisms and therapeutic interventions. World J Orthop 2026; 17(7): 120800 [DOI: 10.5312/wjo.120800]
Corresponding Author of This Article
Hong-Wei Zhang, PhD, Department of Orthopedics, Affiliated Hospital of Gansu University of Traditional Chinese Medicine, No. 732 Jiayuguan West Road, Chengguan District, Lanzhou 730020, Gansu Province, China. 961409730@qq.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
review-article
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Zhi-Peng Wang, Hong-Wei Zhang, Xi-Yun Zhao, Yuan-Zhen Li, Xiao-Gang Zhang, Da-Ping Qin, Department of Orthopedics, Affiliated Hospital of Gansu University of Traditional Chinese Medicine, Lanzhou 730020, Gansu Province, China
Rui Zhao, Da-Ping Qin, Clinical College of Chinese Medicine, Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu Province, China
Author contributions: Wang ZP conceptualized and designed the research, wrote the paper; Zhao XY, Li YZ and Qin DP visualized and performed data analysis; Zhao R searched the literature; Zhang HW revised the early version of the manuscript and supervised the review; Zhang XG revised manuscript; all the authors have read and approved the final manuscript.
AI contribution statement: The author confirms that no AI tools (including but not limited to ChatGPT, Grammarly, DeepL, or other AI-based software) were used in any part of this study. The specific details are as follows: Each part of the text (abstract, introduction, materials and methods, results, discussion, and conclusion) was not generated by AI; no AI tools were used for language polishing, translation, data analysis, or writing assistance; no AI tools were involved in the research design or result interpretation; all images in the manuscript were not generated by AI.
Supported by National Natural Science Foundation Project, No. 82505367; Gansu Provincial Youth Talent Individual Project, No. 2025QNGR72; Natural Science Foundation of Gansu Province, No. 24JRRA1037; The Longyuan Talent Program of the Organization Department of the Communist Party of Gansu Province (Issued by the Provincial Party Committee Talent Team), No. 11; and Youth Science and Technology Program of Lanzhou Bureau of Science and Technology, No. 2023-2-47 and No. 2023-2-48.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Hong-Wei Zhang, PhD, Department of Orthopedics, Affiliated Hospital of Gansu University of Traditional Chinese Medicine, No. 732 Jiayuguan West Road, Chengguan District, Lanzhou 730020, Gansu Province, China. 961409730@qq.com
Received: March 12, 2026 Revised: April 19, 2026 Accepted: June 10, 2026 Published online: July 18, 2026 Processing time: 121 Days and 9.5 Hours
Abstract
Disc degeneration is closely associated with aging and shares similar pathological mechanisms. With advancing age, intervertebral discs undergo structural, biochemical, and biomechanical degeneration, leading to functional impairment and symptoms such as low back pain. During the aging process, factors including extracellular matrix degradation, apoptosis, inflammatory responses, and oxidative stress drive disc degeneration, forming a vicious cycle that accelerates spinal degenerative changes. Recent studies suggest that multi-target pharmacological interventions may slow degenerative progression and alleviate disc-related pathological changes in preclinical models, although clinical evidence remains limited. This review summarizes the shared mechanisms linking disc degeneration and aging, discusses their bidirectional interactions, and evaluates recent advances in pharmacological interventions, with the aim of providing a framework for early intervention and translational research.
Core Tip: This review highlights the shared molecular mechanisms between intervertebral disc degeneration and aging, such as extracellular matrix degradation, apoptosis, inflammation, and oxidative stress. It explores their bidirectional relationship and discusses multi-target pharmacological interventions that show promise in slowing degeneration with favorable safety. The insights provide a theoretical basis for early intervention and precision treatment.
