Degenerative Disc Disease
What are the causes, symptoms, and treatment of Degenerative Disc Disease?
Degenerative Disc Disease involves a variety of structural, biochemical, nutritional and molecular changes that occur in the spinal disc over time or following an initial injury to the intervertebral spinal disc in your spine. Degenerative disc disease is a common cause of back pain and neck pain (discogenic pain), sciatica and radiculopathy. The pain in your back from degenerative disc disease come from irritated (inflamed or compressed) nerve fibers nearby, and can be categorized as a mechanical instability.
What Causes Degeneratve Disc Disease?
An Initial event leading to this spinal disease is injury to annulus fibrosus (the outer layer of the spinal disc containing the inner "jelly" ) leading to annular tear(s). An annular tear may result in a herniated disc, protruding disc, or bulging disc when the inner nulceus of the disc leaks out and into the pathways in the spine where sensitive nerves reside.
Other contributing factors: Trauma to spinal disc, genetics or family history of degenerative disc disease, disc nutrition, and unfavorable spinal biomechanics.
Degenerative disc disease is a combination of structural, biochemical and molecular changes that occur over time within the spinal disc. Not all spinal discs undergo this degenerative cascade of events. Many elderly persons and senor citizens have only a few of their 23 spinal discs degenerate. Most people over the age of 50 have a couple of degenerated spinal discs; fortunately most are without pain or other symptoms.
In summary, most people will have at least one degenerated spinal disc in their lifetime but very few of them have any problems from these discs that are degenerated. Degenerated spinal discs can be a “part of life” like wrinkles or sunspots and most of the time we don’t need to treat them at all. If symptoms like pain, numbness, weakness or tingling of the legs, feet, hands, or arms occur and the degenerated spinal disc is determined to be the source, surgery is often needed. The most common surgery performed to treat symptomatic degenerative disc disease is a spinal fusion. With new, more advanced surgeries like Deuk Laser Disc Repair®, spinal fusion is no longer necessary because the spinal disc is repaired and not removed.
Degenerative Disc Disease is identified most commonly by the structural changes seen on MRI scan or CT scan of the affected region of the spine. These changes include loss of disc height; loss of disc hydration or water content which appears as a “black” disc on T2 weighted MRI sequences; bulging or herniated discs; annular tears; presence of osteophytes or bone spurs; facet degeneration and subluxation; adjacent vertebral endplate changes including sclerosis, irregularity, fractures and edema within the cancellous bone. Some or all of these changes may be present but there is no consensus on what definitively constitutes a degenerated disc. A diagnosis is determined by ordering a MRI, CT, and discogram.
Above: A discogram is performed to determine the cause of back pain or neck pain in cases of degenerative disc disease.
Treatment for degenerative disc disease depends on the duration and severity of discogenic pain; less than 2 months duration may respond well to pain medication, therapy and injections. Discogenic pain lasting longer than 2 months usually requires surgery to effectively relieve painful symptoms. Deuk Laser Disc Repair® is the most effective surgery designed to specifically treat cervical herniated discs and lumbar disc herniations or degenerative disc disease. Older, more invasive treatments include spinal fusion, laminotomy or disc arthroplasty. Read more about this condition.