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CC BY-NC-ND 4.0 · Asian J Neurosurg
DOI: 10.1055/s-0046-1817816
Research Article

Electron Microscopic Insights into Degenerating Lumbar Intervertebral Disc: A Prospective, Cohort Study

Autor*innen

  • Prashant Lakhe 

    1   Department of Neurosurgery, All India Institute of Medical Sciences, Nagpur, Maharashtra, India

  • Chayanika Kutum 

    2   Department of Anaesthesiology, All India Institute of Medical Sciences, Nagpur, Maharashtra, India

  • Anil Kumar BC

    1   Department of Neurosurgery, All India Institute of Medical Sciences, Nagpur, Maharashtra, India

  • Niraj Ghimire

    3   Department of Neurosurgery, Nepalgunj Medical College, Nepal

  • Hukum Singh

    4   Department of Neurosurgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India

  • Vineeta Batra

    5   Department of Pathology, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India

  • Daljit Singh

    4   Department of Neurosurgery, Govind Ballabh Pant Institute of Post Graduate Medical Education and Research, New Delhi, India
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Abstract

Objective

Degenerative disc disease is a leading cause of chronic low back pain, yet radiological and histological assessments often fail to explain symptom severity. Existing studies rarely incorporate electron microscopy (EM), leaving a gap in knowledge regarding cellular and extracellular matrix (ECM) alterations at the ultrastructural level and their relationship with clinical outcomes. This study aimed to investigate ultrastructural changes in lumbar intervertebral disc tissue using EM and to correlate these findings with clinical symptoms and radiological features.

Materials and Methods

A prospective observational study was conducted in 50 patients undergoing lumbar discectomy. Disc tissue was analyzed using EM. Clinical parameters (visual analogue scale [VAS] score, symptom duration) and MRI features (Pfirrmann grading, Modic changes) were recorded and statistically correlated with EM findings.

Results

Chondrocyte clustering (88%) and intracellular inclusion bodies (56%) were the most common EM findings. Both were significantly associated with higher VAS scores (p = 0.02 and p = 0.009, respectively) and longer symptom duration. Chondrocyte clustering and inclusions increased with higher Pfirrmann grades (p = 0.015 and p = 0.022, respectively). No significant association was found between Modic changes and the study outcomes.

Conclusion

EM revealed critical ultrastructural changes in degenerating lumbar discs, with chondrocyte clustering and inclusions emerging as potential morphological markers of disease severity and chronicity.

Keywords

intervertebral disc degeneration - chondrocytes - discectomy - electron microscopy - low back pain

Authors' Contributions

P.L. contributed to conceptualization, methodology, formal analysis, and writing—original draft, review, and editing. C.K. contributed to formal analysis and writing—original draft, review, and editing. A.K.B.C., N.G., and H.S.: data curation and writing—review and editing. V.B. contributed to formal analysis, data curation, and writing—review and editing. D.S. contributed to conceptualization, supervision, and writing—review and editing.


Ethical Approval

The study has received approval from the Institutional Ethics Committee of Maulana Azad Medical College (MAMC), New Delhi, and adheres to the principles outlined in the Declaration of Helsinki.




Publikationsverlauf

Artikel online veröffentlicht:
27. Februar 2026

© 2026. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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