• Cartilaginous endplate degeneration is a central link in intervertebral disc degeneration, characterized by extracellular matrix degradation and increased collagen types I and X.
• The biomechanical properties of the cartilaginous endplate are determined by its extracellular matrix composition, and its degeneration is a cascade reaction triggered by mechanical environment changes.
• Restoring and maintaining a healthy extracellular matrix microenvironment is the main therapeutic direction for intervertebral disc degeneration.
• Multidisciplinary collaboration, including biomechanics and molecular biology, is essential for developing effective treatments such as controlled fixation-traction.