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Home >> Spine Problems >> Degenerative Disc Degenerative Disc Chemical changes in the body cause discs to shrink, occasionally causing them to compress, pinch nerves, or form bony spurs. Overview This condition usually occurs with age, as discs become more brittle, less resilient and more prone to herniation. The most common diagnosis related to serious back and neck pain is degenerative disc disease. When a disc herniates in the spine, the surgeon may in some cases remove a portion of the disc. In contrast, when the disc is more damaged and must be removed, something must be placed into the disc space. Or else, the two vertebrae will collapse on top of one another and increase pressure on the nerve roots that branch off from the spinal cord.
Causes Family history, lifestyle and age are a few of the contributing factors of degenerative disc disease. The average age for disc-related problems is after 35. If a close family member, such as father or brother, had back or neck surgery for a herniated disc, you should put particular emphasis on care for your back. Lifestyle is another significant factor. Over time, individuals who perform frequent lifting or expose the spine to trauma or repetitive shock also have an increased chance of developing degenerative discs. Osteoporosis can lead to disc degeneration. With bone deterioration, a person becomes increasingly at risk for vertebral fractures. Symptoms Degenerative disc disease makes the back more prone to injury and can contribute to the following conditions:
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Diagnosis Outlined below are some of the diagnostic tools that your physician may use to gain insight into your condition and determine the best treatment plan for your condition. Medical history: Performing a detailed medical history allows the doctor improved understanding of the possible causes of your back and neck pain. Moreover, this knowledge may help outline the most appropriate treatment. Physical exam: The physical exam is helpful in allowing your physician to isolate the source of pain. Simple tests for flexibility and muscle strength may also be conducted. MRI (magnetic resonance imaging): Involves magnetic field and radio waves to produce highly detailed pictures of the inside of your body. As x-rays only show bones, MRIs are necessary to envision soft tissues like discs in the spine. This type of imaging is very safe and usually pain-free. CT scan/myelogram: Comparable to an MRI, a CT scan provides diagnostic information about the internal structures of the spine. A myelogram is engaged to diagnose a bulging disc, tumor, or changes in the bones surrounding the spinal cord or nerves. A local anesthetic is injected into the low back to numb the area. A lumbar puncture (spinal tap) is then performed. A dye is injected into the spinal canal to reveal where problems exist. Electrodiagnostics: As part of a diagnostic workup, electrical testing of the nerves and spinal cord may be performed. These tests, called electromyography (EMG) or somato sensory evoked potentials (SSEP), help your doctor understand how your nerves or spinal cord are affected by your condition. Bone scan: In an effort to detect infection, malignancy, fractures and arthritis in any part of the skeleton, bone imaging is used. Bone scans are also helpful in locating lesions for biopsy or excision. Discography: Used to determine the internal structure of a disc. It is performed via local anesthetic and by injecting a dye into the disc under X-ray guidance. Both X-ray and CT scan are performed to establish whether disc composition is normal or abnormal. Additionally, your doctor will note any pain associated with this injection. The benefit of a discography is that it enables the physician to verify the disc level that is causing your pain. This exam helps reduces the risk of operating on the wrong disc as well as ensures surgery will be more successful. Injections: Pain-relieving injections help relieve back pain and give the physician important information about your problem, as well as provide a bridge therapy.
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Treatment Spinal fusion treatment is a typical solution for problems related to this condition. An important problem with fusion surgery is that the outcome is not often good. Even with a success rate of about 75 percent, one in four surgeries can be considered unsuccessful. Another problem with fusion surgery is that mobility is reduced and this can lead to other concerns. The fusion secures a vertebral segment from rotating, this leads to more stress on the level above and below the fused site and in turn may herniate other discs. An improved alternative to fusions exists: artificial disc implantation. Dietary supplements or medications may be recommended to treat degenerative disc disease that is linked to osteoporosis. FAQ What is degenerative disc disease? A natural byproduct of aging is the loss of resiliency in spinal discs and a greater tendency for them to herniate, especially when placed under a weighty load, like when we lift heavy objects. Further, a family history of degenerative disc disease can also increase the risk. When a natural disc herniates or becomes badly degenerated, it loses its ability to absorb shock, which can narrow the space between vertebrae. Who is a candidate for the artificial disc? Patients with an unhealthy disc between L4 and L5 or between L5 and S1 (all in the lower back) that is severely damaged or injured and causes back pain are candidates for the artificial disc. Other candidates include those with degenerative disc disease (DDD) whose bones (vertebrae) have moved less than 3mm. Your physician will help you determine whether or not the artificial disc is a good choice for you. Factors that will be considered include your activity level, weight, occupation and allergies. What are the benefits of the artificial disc? In the norm, individuals who receive artificial disc replacements return to activity sooner than traditional fusion patients. Also, as there is no need to harvest bone from the patient’s hip, there is not added discomfort or recovery associated with a second incision site. Some of the overall benefits of artificial disc surgery include:
While the artificial disc may well be a promising new technology, most spine surgeons today are very cautious. There are many serious concerns including:
What happens if the implant needs to be removed? Partner with your spine surgeon to determine your best option. Learn more about the artificial disc. |
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