Causes Degenerative disc disease
The discs hold a soft gel-like substance that prevents friction. With age, the spinal discs degenerate and undergo changes like:
- Loss or drying of disc fluid: This affects the shock absorption capacity of the discs and its flexibility. The disc narrows down and the gap between disc and vertebrae increases.
- Bulging disc or herniation: Weakness or external injury results in a minor crack on the outer layer of the disc. The gel substance leaks out and with movement, it is forced out of the gaps. This can cause the disc to bulge, rupture or break.
- Bone spur: If the disc narrows or cracks, the gap between disc and vertebrae increases and the spine become less stable.
- The body responds to this by initiating bony growths called bone spurs also known as osteophytes. These spurs can exert pressure on the spinal cord or nerve roots that shoot from the cord.
- People with jobs or hobbies that involve heavy weight lifting, can face this issue. Smokers, elderly people or people with a past injury can also suffer from degenerative disc disease.
How is degenerative disc disease diagnosed?
It begins with understanding the medical history and a thorough physical exam. The doctor will seek information on the symptoms, duration, past injuries, illnesses or lifestyle, habits, nature of everyday activities, etc.
The second step would be to check the range of motion, muscle strength, ease of movement, nerve reflexes, tenderness, and inflammation is any. The doctor might also check for fractures or infections. Post this the patient has suggested Imaging tests that will identify the level of compression and exact location of the damage.
Treatment for degenerative disc disease
- Medication and hot/cold packs help ease the pain. If the pain is unbearable, the doctor will prescribe stronger pain reliefs and application ointments.
- The next step is physical therapy, where the therapist will move every joint in a specific sequence. It involves stretching and strengthening the muscles in the back.
- Surgery is the last resort. It depends on the type of degeneration and is necessary if the spinal cord or nerves are compressed either by the narrowing canal or the bulging disc or maybe the bony spurs.
Traditional decompression surgeries performed from the back (posterior) of the spine are:
Facetectomy: Spinal joints called facet joints are removed if they exert pressure on the nerve or cord.
Foraminotomy: Enlargement of the opening is made for the nerve to exit without pressure in case a part of the disc or bone spur blocks its path.
Laminectomy: Lamina is the posterior portion of the vertebrae that protect the spinal canal and cord. If it is pressing the spinal cord, surgery is done to remove part or whole of the lamina to ease the pressure on the cord.
Laminotomy: Similar to the foraminotomy, a bigger opening is made in the lamina if it is pressing a nerve structure. The nerves are given more space to exit the cord and reach the limbs.