Send to:

Choose Destination
See comment in PubMed Commons below
Eur Spine J. 2016 Jan;25(1):144-54. doi: 10.1007/s00586-015-3917-y. Epub 2015 Apr 18.

Disc herniations in astronauts: What causes them, and what does it tell us about herniation on earth?

Author information

  • 1Center of Muscle and Bone Research, Charité University Medicine Berlin, Hindenburgdamm 30, 12203, Berlin, Germany.
  • 2Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
  • 3Centre for Comparative and Clinical Anatomy, University of Bristol, Southwell Street, Bristol, BS2 8EJ, UK.
  • 4Department of Orthopedics, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenborg, Sweden.
  • 5Department of Orthopedics, Sahlgrenska University Hospital, Gothenborg, Sweden.
  • 6Department of Rehabiliation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 3B3, 9000, Ghent, Belgium.
  • 7Department of Rehabiliation Sciences and Physiotherapy, Ghent University, De Pintelaan 185 3B3, 9000, Ghent, Belgium.
  • 8Nuffield Orthopaedic Centre, Headington, Oxford University Hospitals NHS Trust, Oxford, OX3 7HE, UK.
  • 9Department of Orthopaedic Surgery, University of California, San Diego, San Diego, CA, 92103-8894, USA.
  • 10Bioengineering Building, Stony Brook University, Stony Brook, NY, 11794-5281, USA.
  • 11Johnson Space Center, 2101 NASA Parkway SD4, Houston, TX, 77058, USA.
  • 12Centre for Military Medicine, Satakunta Air Command, PO.Box 1000, 33961, Pirkkala, Finland.
  • 13Department of Physiology, Anatomy and Genetics, Oxford University, Le Gros Clark Building, South Parks Road, Oxford, OX1 3QX, UK.
  • 14Faculty of Human Movement Sciences, MOVE Research Institute Amsterdam, VU University Amsterdam, van der Boechorststraat 9, Amsterdam, 1081 BT, The Netherlands.
  • 15Institute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89081, Ulm, Germany.



Recent work showed an increased risk of cervical and lumbar intervertebral disc (IVD) herniations in astronauts. The European Space Agency asked the authors to advise on the underlying pathophysiology of this increased risk, to identify predisposing factors and possible interventions and to suggest research priorities.


The authors performed a narrative literature review of the possible mechanisms, and conducted a survey within the team to prioritize research and prevention approaches.


Based on literature review the most likely cause for lumbar IVD herniations was concluded to be swelling of the IVD in the unloaded condition during spaceflight. For the cervical IVDs, the knowledge base is too limited to postulate a likely mechanism or recommend approaches for prevention. Basic research on the impact of (un)loading on the cervical IVD and translational research is needed. The highest priority prevention approach for the lumbar spine was post-flight care avoiding activities involving spinal flexion, followed by passive spinal loading in spaceflight and exercises to reduce IVD hyper-hydration post-flight.


Atrophy; Back pain; Bed rest; Inactivity; Muscle; Prolapse

[PubMed - in process]
PubMed Commons home

PubMed Commons

How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Write to the Help Desk