Low back pain (LBP) is the leading factor for global disability and lost productivity in the workplace, and Americans alone spend in excess of 50 billion dollars on LBP treatment1. Although prevalent, the etiology of LBP remains complex and multifactorial. However, intervertebral disc (IVD) degeneration is among the most significant risk factors for LBP2.
The IVD is made of three microstructures: the exterior annulus fibrosis (AF), the interior nucleus pulposus (NP), and two cartilaginous endplates that sandwich the whole structure proximally and distally3. With aging and degeneration, the IVD components change structurally, compositionally, and mechanically4. These changes include the loss of proteoglycans and hydration in the NP, decreased disc height, and deteriorated mechanical competence5. These alterations are often accompanied by cytokines that promote an inflammatory response, as well as neutrophil and dorsal root ganglion intrusion into the joint space culminating in a cascade of events that lead to LBP symptoms6.
Studying the mechanisms of IVD degeneration is challenging in humans because it is often not possible to isolate the cause of the degeneration before the occurrence of low back pain. Thus, a reductionist approach of simplifying the experimental system down to the IVD organ allows mechanistic fine-tuning of causal variables and examining their downstream effects5. The system is reduced to only the native cell population and surrounding extracellular matrix, thus enabling the direct interpretation of the effects of external stimuli on IVD degeneration. Moreover, the lower cost and scalability of murine models, as well as the large number of genetically modified animals7, allow for the rapid targeted screening of IVD degenerative mechanisms and potential therapies. Here, we describe a murine organ culture system in which IVD cellular and tissue stability is maintained over 21 days, with specific focus given to the IVDs' homeostatic, mechanical, structural, and inflammatory patterns. Using this method, we monitor the IVDs' functional changes in a stab-induced injury model8 to understand the mechanisms behind disc degeneration. Furthermore, we describe several applications of this organ culture method to conduct further studies including contrast-enhanced microCT imaging and three-dimensional high-resolution modeling of the IVD.