• Vascular-lymphatic imbalance and immune microenvironment changes interact to accelerate intervertebral disc degeneration.
• Increased VEGF expression in degenerated discs may aid nutrient supply but also elevates pro-inflammatory factors like MMP-3, inhibiting type II collagen synthesis.
• The complex interplay between vascular-lymphatic disruption and immune microenvironment remains poorly understood, with current studies only revealing expression changes.
• Further research is needed to elucidate the temporal and dynamic regulation of vascular-lymphatic and immune microenvironment changes in specific stages of disc degeneration.