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.

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Fusion Procedures

Fusion procedures can be performed in a variety of ways. Whether the procedure is performed from the front, side, or back, the objective is to remove the degenerated disc and replace it with a cage to help fuse the bones together to help alleviate the symptoms. Stability can further be added with plates, rods, and screws. The fusion can usually be performed by a minimally invasive procedure, by going from the front (ALIF), side (LLIF), or back (TLIF).

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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Dr. Patrick Horan and the other orthopedic surgeons and specialists at Westchase Orthopedics & Rehabilitation have served hundreds of patients in the Tampa Bay area. Our patients choose us because we are able to offer them viable solutions to their pain. We offer hope to patients who have been athletes for years and suddenly find themselves faced with the possibility of never playing again, to elderly patients who want to maintain their independence and do things like drive and grocery shop alone, to parents who aren’t sure what is wrong with their children’s knees or elbows and want answers. Unlike in many other practices, you are not treated like just a number; we take the time to listen to your concerns and symptoms, accurately diagnose the source of the problem, and walk you through what will happen during the course of treatment. Get in touch with our office today to schedule an appointment!

Testimonials

Dr Horan has done a few of my knee surgeries and has always been the best surgeon. Dr Lao has been my physical therapist for every knee surgery and his results are proven and outstanding. I’d be in bad shape if it wasn’t for dr Lao and his staff who go above and beyond to do what’s needed.

Testimonials

Dr. Lao is simply the best! His intense educational training and specialty of the spine are something that you seldom come across these days. When I lived in Bradenton for 9 months I would drive over an hour just to see him because he was the only one I trusted with my physical issues. His assistant Sam is wonderful and Lisa at the front desk is always very helpful! There is another PT there that I have not treated with, but I only hear great things about him! 🙂 I will not go anywhere else.

Testimonials

This review encompasses both Dr Horan's orthopaedic side of the business & Dr Lao's physical therapy side. I have no idea if their practices are actually related, but there's only one street sign & only one Yelp check-in. Luckily, I think both doctors are excellent.

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