Obesity-induced intervertebral disk degeneration: pathophysiology and clinical implications

Obesity is a significant public health issue that has been increasingly linked to various musculoskeletal disorders, including intervertebral disk degeneration (IVDD). The interplay between metabolic dysfunction, chronic inflammation, and biomechanical stress suggests a multifactorial link between obesity and IVDD, warranting further investigation. This review aims to explore the pathophysiological mechanisms through which obesity contributes to IVDD and discuss this relationship's clinical implications. Obesity induces an occurrence of minor chronic inflammation and metabolic abnormalities, which can exacerbate degenerative changes in the intervertebral disks. Pro-inflammatory cytokines (TNF-α and IL-6) secreted by visceral adipose tissue can promote disk degeneration by enhancing catabolic processes and inhibiting anabolic repair mechanisms within the disk matrix. Additionally, mechanical loading due to excess body weight increases stress on the spinal structures, accelerating wear and tear of the intervertebral disks. This review summarizes current research findings on the biochemical and biomechanical pathways linking obesity to IVDD. We examine evidence from epidemiological studies, clinical trials, and animal models that highlight the multifaceted impact of obesity on spinal health. Furthermore, we discuss the implications of these findings for clinical practice, emphasizing the importance of weight management in preventing and treating IVDD. Interventions such as lifestyle modifications, dietary changes, and bariatric surgery are evaluated for their effectiveness in mitigating the adverse effects of obesity on the spine. The review also addresses the potential for targeted pharmacological therapies that modulate inflammatory pathways and mechanical stress responses. Understanding the association between obesity and IVDD is crucial when establishing all-encompassing management approaches for those who are impacted by the growing global prevalence of obesity. By elucidating the pathophysiological underpinnings and clinical consequences of obesity-induced IVDD, this review aims to inform future research directions and clinical guidelines, ultimately improving patient outcomes in this growing population.