As we get older, our spinal discs dehydrate, which diminishes their flexibility and capacity to act as shock absorbers between vertebrae. The bones and ligaments that make up the spine also thicken and become less flexible. The tough outer layer of the discs can then tear or crack, leaving them susceptible to herniation.
What are the symptoms of degenerative disc disease?
The affliction can take place throughout the spine, but it most often affects the discs in the lower back and neck. Degenerative disc disease is often asymptomatic. There may be an aching pain in the buttocks and or the backs of the thighs, aggravated while walking or sitting. Neck pain is common; however, the shoulders, arms, and hands may also be affected. Bending, lifting, twisting, or even sneezing or coughing might trigger a reaction, which could include burning, tingling, or numbness.
Treatment for degenerative disc disease
Physicians evaluate low back pain by conducting a medical history, a physical exam and selected diagnostic tests. “Most doctors initially recommend a conservative approach unless there is concern that permanent neurological damage might have occurred,” says Dr. Liu, who explains that surgery may be advised if a patient has lost bowel or bladder control. Many symptomatic cases resolve with bed rest, physical therapy, and anti-inflammatory medication. Treatment for degenerative disc disease can also include an epidural steroid that relieves pain by delivering medication directly to the affected area.
Surgery for degenerative disc disease
Quality of life is the litmus test: If someone experiences debilitating pain with little improvement during months of conservative treatment, a physician may recommend an operation. Degenerative disc disease surgery usually involves removing the damaged disc. The operation may be performed as an open procedure or a minimally invasive procedure. With an open procedure, the surgeon cuts open the skin around the problem area to gain access to your spine. The bone is then permanently fused to protect the spinal cord. In rare cases, an artificial disc may be used to replace the disc that is removed. One of the long-term consequences of this fusion can be accelerated degeneration of adjacent discs, leading to more rapid degeneration of those discs than might have occurred without the adjacent fusion.
Minimally invasive procedures such as endoscopic spine surgery for degenerative disc disease only require a small incision, resulting in a quicker recovery and less risk of complications. A tiny metal tube is inserted into the spinal nerve hole. Surgical tools are then inserted into the tube with no need to cut or tear surrounding muscle and tissue. The surgeon can then gently manipulate the surrounding muscles and tissues, instead of the cutting and tearing that happens during traditional open back surgery.
Pioneering studies in degenerative disc disease treatment
A new stem cell study may offer hope for an alternative to back surgery. Scientists are researching the efficacy of using adult donor bone marrow stem cells to administer stem cell injections into degenerative discs. Their hope is that these stem cells will regenerate deteriorating intervertebral discs and reverse damage.
Bio: About Dr. Liu: Kaixuan Liu, M.D., Ph.D., is a renowned endoscopic spine surgeon and founder of Atlantic Spinal Care, LLC, in Edison, New Jersey (http://www.atlanticspinalcare.com). Dr. Liu is certified by The American Board of Pain Medicine and The American Board of Anesthesiology, and is a member of The International Society for Advancement of Spine Surgery, The American Society of Interventional Pain Physicians (ASIPP), The American Academy of Pain Medicine (AAPM), The International Intradiscal Therapy Society (IITS), and The American Society of Anesthesiologists (ASA). He also serves as an international surgeon for The Spinal Foundations in England.
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