Intervertebral disc cell fate during aging and degeneration: apoptosis, senescence, and autophagy

•The intervertebral disc is the largest avascular, low-nutrient organ in the body.•Disc cells undergo limited nutrition and inflammation during aging and degeneration.•Apoptosis and senescence increase in incidence with age and degeneration severity.•Autophagy can be activated earlier, but impaired in aged, degenerated discs.•The mammalian target of rapamycin is a signal integrator to determine disc cell fate.