As the two vertebrae above and below the affected disc begin to collapse upon each other, the facet joints at the back of the spine are forced to shift which can affect their function.Additionally, the body can react to the closing gap between vertebrae by creating bone spurs around the disc space in an attempt to stop excess motion. This can cause issues if the bone spurs start to grow into the spinal canal and put pressure on the spinal cord and surrounding nerve roots as it can cause pain and affect nerve function. This condition is called spinal stenosis. For women, there is evidence that menopause and related estrogen-loss are associated with lumbar disc degeneration, usually occurring during the first 15 years of the climacteric. The potential role of sex hormones in the etiology of degenerative skeletal disorders is being discussed for both genders.Mutations in several genes have been implicated in intervertebral disc degeneration. Probable candidate genes include type I collagen (sp1 site), type IX collagen, vitamin D receptor, aggrecan, asporin, MMP3, interleukin-1, and interleukin-6 polymorphisms. Mutation in genes – such as MMP2 and THBS2 – that encode for proteins and enzymes involved in the regulation of the extracellular matrix has been shown to contribute to lumbar disc herniation. Mechanisms
Degenerative discs typically show degenerative fibrocartilage and clusters of chondrocytes, suggestive of repair. Inflammation may or may not be present. Histologic examination of disc fragments resected for presumed DDD is routine to exclude malignancy.
Hydrochlorothiazide/triamterene, also known as co-triamterzide, is a fixed-dose combination medication of hydrochlorothiazide and triamterene. It is used to treat high blood pressure and edema (swelling). Specifically it is used in those who develop low blood potassium (hypokalemia) when on only hydrochlorothiazide. It is taken by mouth.Side effects may include nausea, trouble sleeping, dizziness, feeling light headed with standing, kidney problems, allergies, and muscle cramps. Other serious side effects may include high blood potassium. Use in pregnancy and breastfeeding is not generally recommended. Use in those with significant kidney problems is not recommended. It decreases blood pressure mainly by hydrochlorothiazide while triamterene decreases the amount of potassium lost.The combination was approved for medical use in the United States in 1965. In 2019, it was the 115th most commonly prescribed medication in the United States, with more than 5 million prescriptions. References
External links
"Hydrochlorothiazide mixture with triamterene". Drug Information Portal. U.S. National Library of Medicine.