SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025
Lumbar disc herniation modelling: a review of ex-vivo mechanical models and a comparison with clinical data.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed.
- Nucleus Pulposus Resorption Following a Paraspinal Hook-Needle Intervention for Lumbar Disc Herniation: A Case Report.Clinical case reports · 2026Article
- Minor endplate damage as an initiator of systemic biomechanical disruption of the lumbar disc: a finite element analysis of the 'mechanical tipping point' in disc failure.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Biomechanical analysis of lumbar oblique manipulation for lumbar disc herniation with different protrusion subtypes.Mechanobiology in medicine · 2026Article
- Patient-reported outcome measures in lumbar disc herniation: a scoping review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- How I do it: The K-point approach in unilateral biportal endoscopic lumbar discectomy: a bone and ligamentum flavum preserving technique.Acta neurochirurgica · 2026Article
- Mechanical and Biological Treatments for Annulus Fibrosus Repair and Closure: A Review of Clinical Studies.Neurospine · 2026Review
- The Biomechanical Landscape of Lumbar Disc Herniation: Mechanobiological Insights Into Injury and Regeneration.Neurospine · 2026Review
- Can cervical disc herniations be provokedFrontiers in bioengineering and biotechnology · 2026Article
- Lumbar Disc Herniation Resorption: When and How Does It Occur?Neurospine · 2026Review
- Article
- A Comparison of Five Animal Models for Acute Intervertebral Disc Herniation Research.JOR spine · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
purposeEx-vivo herniation models are essential for studying lumbar disc herniation mechanisms, but their morphological accuracy remains unclear due to limited validation against patient-derived clinical data. This review collates clinical lumbar disc herniation characteristics and evaluates whether existing models replicate real-world pathology. By identifying the most morphologically relevant models, this study provides a stronger foundation for improving mechanistic herniation models.
methodsA systematic review following PRISMA guidelines identified clinical studies detailing herniation characteristics and experimental models of ex-vivo lumbar disc failure. Models were categorised by loading conditions (complex ultimate compression; cyclic; and intradiscal pressurisation), then compared to clinical data to assess their validity.
resultsIn patients, extrusions (50%) and protrusions (34%) are the most common lumbar disc herniation types, with paracentral herniations (61%) predominantly occurring at L4-L5 (49%) and L5-S1 (42%). Structural failure patterns varied, with annulus fibrosus failure reported in 35-81% of cases and endplate junction failure in 19-68%. Among 25 analysed models, all loading types induced herniations, but often with different damage patterns. Complex ultimate compression caused abrupt failures and fractures, while cyclic led to progressive annular damage. Intradiscal pressurisation highlighted nucleus pulposus migration pathways. Within a single herniation model, the damage mechanisms seen were similar between discs.
conclusionsClinical herniation patterns show significant variability, while ex-vivo models yield more repeatable outcomes. Cyclic, complex ultimate compression, and intradiscal pressurisation models provide valuable mechanistic insights but differ in physiological relevance. Researchers must consider the physiological relevance of the applied load and the differences between animal and human discs when selecting a model. Future research should focus on understanding herniation progression and identifying initiating factors to improve prevention strategies.
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Registered trials
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