Disc Anatomy
The intervertebral disc is composed of a ring called the annulus fibrosis that encloses a gelatinous inner structure called the nucleus pulposus. The discs are kept in position with the help of endplates between two vertebral bodies. The intervertebral discs act as shock absorbers, aiding in spine flexibility and reducing inflammation caused by pressure and degeneration.
What is Degenerative Disc Disease?
Degenerative disc disease (DDD) refers to the gradual deterioration of the intervertebral discs between the vertebrae, a process known as disc degeneration. DDD is a misnomer as it is not actually a disease but a condition that affects the strength, resilience, and structural integrity of the intervertebral discs due to the aging process, trauma, injury, repetitive movement, improper posture, or poor body mechanics. Risk factors such as obesity and heavy lifting can also contribute to this degeneration.
DDD is commonly seen in individuals over 50 years of age, affecting about 20% of adults by age 65. Most of them are usually not aware of their condition until they are examined for some other related health condition or when symptoms like pain, numbness, or tingling caused by compressed nerves or spinal stenosis lead them to seek medical attention.
Diagnosis typically involves a thorough medical evaluation by a degenerative disc disease Dallas specialist, including imaging studies such as MRI, X-ray, or CT scans to assess nerve function and confirm the extent of disc degeneration.
Causes of Degenerative Disc Disease
As we age, the rate at which the old, worn-out cells are replaced is gradually reduced, resulting in degenerative changes in the discs due to advancing age. This can also be accelerated by injury or trauma, including a tear in the disc.
These structural changes can cause a sequence of other changes, resulting in nerve compression and pain due to reduction in the disc height, and the presence of bone spurs or bony overgrowths (osteophytes). Other conditions such as spinal stenosis and osteoarthritis (spondylosis) can also affect the intervertebral joints and spinal stability, impacting the ability to bend, twist, and perform specific movements.
Symptoms of Degenerative Disc Disease
Every patient is different, and it is important to realize that not everyone develops symptoms because of degenerative disc disease. When the condition becomes painful or symptomatic, it can cause several different symptoms due to the compression of the nerve roots, including numbness, tingling, and weakness. Depending on the location of the degenerative disc, it could cause lower back pain, radiating leg pain, cervical neck pain, and radiating arm pain.
As the discs between the intervertebral bodies start to degenerate and lose fluid, the entire lumbar spine loses flexibility, resulting in back pain, stiffness, and difficulty with twisting movements.
Diagnosis of Degenerative Disc Disease
The process comprises a complete medical history and physical examination by your spine doctor to diagnose degenerative disc disease. The examination of the back for flexibility, range of motion, and the presence of certain signs that suggest nerve root injury helps detect the degenerative changes. This is done by testing your muscle strength and your reflexes, as part of the first appointment, to make sure that they are still functioning normally.
A series of X-rays may also be performed. If degenerative disc disease is present, the X-rays will often show a narrowing of the spaces between the vertebral bodies, which indicates that the disc has become very thin or has collapsed. Bone spurs formed around the edges of the vertebral bodies and facet joints in the spine can also be viewed on an X-ray, helping spine surgeons plan available treatments. As a result, the space available for the nerve roots begins to shrink, which can cause pain radiating to the buttocks and other areas. The nerve roots exit the spinal canal through a bony tunnel called the neural foramen, and it is at this point that the nerve roots are especially vulnerable to compression, which may require a surgical procedure such as spinal fusion to treat the condition effectively.
In most cases, imaging tests like MRI or CT scan may be ordered to evaluate the degenerative changes and determine disc herniation and nerve root compression, and to rule out other conditions. A CT scan can show the amount of space available for the nerve roots, as well as the space within the neural foramina and spinal canal.
Treatment of Degenerative Disc Disease Dallas
Both surgical and non-surgical treatment options are available for degenerative disc disease treatment. The choice of treatment depends on various factors such as your age and the severity of the disease.
Conservative treatment such as medication, rest, exercise, and physical therapy (focusing on core stabilization and flexibility) is usually recommended if your diagnosis has not shown any evidence of nerve root compression or muscle weakness. Non-surgical treatments may also include interventional pain management techniques such as epidural steroid injections and radiofrequency ablation to provide relief.
Surgery is suggested only after conservative treatment options fail to adequately relieve your symptoms of pain, numbness, and weakness over a significant period. Decompression of the spinal cord along with a discectomy and fusion surgery will be performed by your degenerative disc disease Dallas doctor to remove the affected disc and fuse the adjoining vertebrae to stabilize the spine.
