Degenerative

Disc Disease

Degenerative Disc Disease

Nearly everyone’s spinal discs show signs of wear as they get older. But not everyone will have degenerative disc disease. While it is not actually a disease, this is a condition in which a damaged disc causes pain. A wide range of symptoms and severity is associated with this condition.

The discs act like shock absorbents between the bones of the spine and are designed to help the back stay flexible while resisting forces in many different planes of motion. Each disc has two parts:

  • A firm, outer layer, the anulus fibrosus. The outer portion of this layer contains nerves. If the disc tears in this area, it can become very painful.
  • A soft, squishy core, the nucleus pulposus. This part of the disc contains proteins that can cause the tissues they touch to swell  and become tender. If these proteins leak out to the nerves of the outer layer of the disc, they can cause a great deal of pain.

Unlike other tissues of the body, the disc has very low blood supply. Once a disc is hurt, it cannot repair itself, and a spiral of degeneration can set in with three stages that appear to occur over 20 to 30 years:

  • Acute pain makes normal movement of the back very hard
  • The bone where the injury occurred becomes unstable. Over a long period of time, the patient will have back pain that comes and goes periodically.
  • The body re-stabilizes the injured segment of the back. The patient experiences fewer bouts of back pain.

What causes degenerative disc disease?

Several factors can cause discs to degenerate, including age. Specific factors include:

  • The drying out of the disc. When we are born, the disc is about 80 percent water. As we age, the disc dries out and does not absorb shocks as well.
  • Daily activities and sports, which cause tears in the outer core of the disc. Around age 60, most people have some degree of disc degeneration. Not everyone at that age has back pain, however.
  • Injuries, which can cause swelling, soreness and instability. This can result in low back pain.

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Symptoms a patient may experience from a degenerate disc disease can include:

Pain that is worse when sitting. While seated, the discs of the lower back have three times more load on them than when standing.

Pain that gets worse when bending, lifting or twisting.

Feeling better while walking or even running than while sitting or standing for long periods of time.

Feeling better changing positions often or lying down.

Periods of severe pain that come and go. These last from a few days to a few months before getting better. They can range from nagging pain to disabling pain. Pain can affect the low back, buttocks and thighs or the neck, depending on where the affected disc is, radiating to the arms and hands.

Numbness and tingling in the extremities.

Weakness in the leg muscles or foot drop, a possible sign of damage to the nerve root.

Minimally invasive procedures that may be considered when suffering from degenertive disc disease:

Total Disc Replacement

Cervical total disc replacement is a surgical procedure that involves removing a damaged or compromised cervical disc and replacing it with a prosthesis to add support and structure in between the cervical vertebral segments while still m…

Laminotomy

A laminotomy is a surgical procedure where a small portion of the lamina is removed from the vertebral body so that decompression may be achieved. A laminotomy is typically performed in conjunction with other decompressive procedures such…

ACDF

Anterior Cervical discectomy and fusion (ACDF) is a surgical procedure that involves fixation of cervical vertebral segments to achieve decompression in the cervical spine. Anterior cervical discectomy and fusion is a very common procedur…

Foraminotomy

A minimally invasive foraminotomy is a procedure that is typically done in conjunction with other spinal procedures that can include laminotomy, discectomy, and possibly other decompressive procedures. In understanding spinal anatomy and …

Percutaneous Discectomy

A percutaneous discectomy is a surgical procedure that involves removal of disc material that may be causing spinal cord or nerve root irritation and inflammation. A discectomy is typically performed on bulging herniated, or protruding di…

Epidural Steroid Injection

Epidural steroid injections (or ESI) are typically performed after non-invasive measures (physical therapy and/or chiropractic) have failed. An ESI procedure involves delivering a steroid medication directly to the site of the inflammation…

Spinal Cord Stimulator

Spinal cord stimulators involve implanting a neurostimulation device that assists in interrupting nerve related pain signals before your brain can register the feeling of pain. With spinal cord stimulators they are often recommended for …

Tranforaminal Lumbar Interbody Fusion

Trans-foraminal lumber interbody fusion is a surgical procedure that involves placing implants (also know as a cage or space) in between lumbar vertebral segments with bone graft to achieve fusion of the vertebrae. This procedure is often…

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