Figure 2.

Factors influencing IVD microenvironment. Over time, intervertebral discs lose their integrity and structure (a) and undergo a degenerative process. Factors contributing to disc degeneration include hypoxia, low nutrient conditions, hyperosmolarity (excess leads to catabolism), acidity (pH), and inflammation. These factors lead to a decline in the balance between extracellular matrix production and apoptosis, resulting in a degenerated intervertebral disc (b).