Degenerative Disc Disease
What is it?
Degenerative disc disease is not really a disease but a term used to describe the normal changes in your spinal discs as you age. Spinal discs are soft, compressible discs that separate the interlocking bones (vertebrae) that make up the spine. The discs act as shock absorbers for the spine, allowing it to flex, bend, and twist. Degenerative disc disease can take place throughout the spine, but it most often occurs in the discs in the lower back (lumbar region) and the neck (cervical region).
Causes and Risk Factors
When we are born, the disc is about 80% water. As we age, the disc dries out and doesn’t absorb shocks as well. This reduces the ability of the discs to act as shock absorbers and makes them less flexible. Loss of fluid also makes the disc thinner and narrows the distance between the vertebrae.
The jellylike material inside the disc (nucleus) may be forced out through the tears or cracks in the capsule, which causes the disc to bulge, break open (rupture), or break into fragments.
These changes are more likely to occur in people who smoke cigarettes and those who do heavy physical work (such as repeated heavy lifting).
People who are obese are also more likely to have symptoms of degenerative disc disease.
A sudden (acute) injury leading to a herniated disc (such as a fall) may also begin the degeneration process.
Symptoms:
Degenerative disc disease may result in back or neck pain, but this varies from person to person.
- 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.
- Numbness and tingling in the extremities
Surgical Treatments
Degenerative disc disease surgery is often the last resort for patients whose pain from degenerative disc disease is so severe that it restricts their ability to work or perform other daily activities. Surgery usually is only recommended if symptoms have not responded to non-surgical treatments like medication, exercise or physical therapy.
Surgical Interventions
- Artificial disc replacement
- Anterior lumbar interbody fusion (ALIF)
- Anterior cervical discectomy and fusion
- Chiari malformations
- Kyphoplasty
- Posterior lumbar interbody fusion (TLIF)
- Scoliosis treatment
- Spondylosthesis
- Transforminal Lumbar Interbody Fusion (TLIF)
- Vertebral tumors
- Video-Assisted Thoracic Surgery (VATS)
- Minimally Invasive Spine Surgery
A microdecompression is often performed for lumbar disc herniation. The purpose of this procedure is to remove a small portion of the bone (microdiscectomy) over the nerve root and/or disc material from under the nerve root. This relieves the pinched nerve and eases pain.