Degenerative Disc Disease
What you need to know
Occurs during the natural aging process and is often referred to as arthritis in the neck and back. It can also be the result of longstanding repetitive trauma.
The disc is the material in between the two vertebrae which acts as a shock absorber and cushion to reduce compression forces. As the disc ages, it loses its elasticity and water content which causes the disc to collapse and stiffen. Sometimes a tear can arise in the outer layer of the disc called the annulus, causing the inner part of the disc called the nucleus pulposis to bulge or herniate, which can compress the nerves to produce arm or leg pain. The bones then begin to rub on one another which can produce bone spurs which can narrow the space for the spinal nerves, causing arm or leg pain. Sometimes the disc can degenerate whereby the stability is lost, and the vertebral bodies begin to slide on top of one another called spondylolisthesis. When the degeneration of the disc is asymmetric with wear and tear developing more on one side, a curvature or degenerative scoliosis can develop.
Pain in the neck or lower back region is usually exacerbated by sitting and bending, which increases the force and pressure on the disc in that position. Repetitive bending, lifting, smoking, and obesity can be significant risk factors to increase the degenerative process. Pain is usually relieved by laying down. Plain x-rays can show the disc height collapse and bone spur formation. An MRI scan shows the degeneration, tears in the periphery of the disc and any disc bulging producing the symptoms. A CT scan can be used in certain cases whereby an MRI cannot be obtained. This will typically show the disc collapse and bone spur formation and in severe cases gas formation within the disc space.
Non-steroidals, physical therapy and spinal injections can be used to control symptoms. A surgical solution which usually includes a fusion procedure is considered in patients who fail conservative treatment.
Newer advances with disc replacement technology help to maintain motion, reducing the stress and wear on the sub-adjacent levels.
Patrick J. Horan, MD, MBA, FACS
Patrick J. Horan is an orthopaedic surgeon and sports medicine specialist with two decades of experience. He is board-certified in orthopaedic surgery and sports medicine. After receiving his undergraduate degree from Duke University in Durham, N.C., Dr. Horan earned his medical degree from Tufts University School of Medicine in Boston. Residency and Internship were both completed at Walter Reed Army Medical Center in Washington, D.C. He also received an MBA from Auburn University in Auburn, Ala.
Dr. Horan served 10 years on active duty in the US Army as an orthopaedic surgeon before entering into private practice. Dr. Horan is the founder of the Westchase Orthopaedic and Rehabilitation and the official surgeon of the Tampa Bay Rowdies. He maintains professional memberships with the American Academy of Orthopaedic Surgeons, the American Academy of Orthopaedic Sports Medicine and the Arthroscopy Association of North America.
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