Degenerative Disc Disease

Degenerative Disc Disease, or DDD, occurs in many people as part of the normal aging process. It is sometimes referred to as arthritis of the back. The condition results from changes in the compressible spinal discs, which act as and shock-absorbing cushions between the vertebrae. With age, the discs can lose fluid, making them less flexible and more compressed, or they can develop tiny tears in the outer layer (annulus), which can cause pain by themselves or allow the jellylike inner layer (nucleus) to bulge, causing pressure on the spinal cord and/or nerves.

The most common symptom of DDD is deep aching lower back pain that can radiate to the top of the thighs. Pain in the morning is usually described as stiffness in the lower back. The condition can occur anywhere along the spine, but is most common in the neck (cervical) and lower back (lumbar) regions. The resulting neck or lower back pain is usually made worse by certain activities or prolonged sitting and standing. There may be bouts of severe pain, lasting from a few days to several months, before returning to a milder long-term, chronic pain. Many people don’t realize they have disc degeneration because it frequently causes no pain at all.

The cause of DDD is typically the normal wear and tear that occurs in the discs as a person ages. However, it can occasionally be caused by trauma (injury) or repetitive lifting. The affected disc becomes thinner and loses its cushioning ability. These changes affect the way the vertebrae in the spine move and bone spurs can result as well as bulging or disc leakage, all of which can cause pain when they contact the spinal nerves. Smoking, obesity, heavy lifting, and hereditary factors also lead to advanced degeneration.

DDD causes lower back pain in most people at some point in their lives. Symptoms usually resolve on their own; occasionally, medications and non-operative treatments (physical therapy) are needed. Surgery is performed for those whose symptoms do not improve

Treatment Options

  • Non Operative Treatment - Medications, physical therapy or spinal cortisone injections are indicated for pain relief. Surgery an be considered for those who do not improve.
  • Decompression - This surgical procedure involves removing all or portions of the lamina, removing bone spurs and/or enlarging foramina to relieve pressure or compression on the nerve roots or spinal cord. This pressure is often the cause of the pain.
  • Decompression & Posterolateral Fusion - Often times, in addition to a decompression, your surgeon will perform an instrumental posterolateral fusion by inserting a series of screws and rods coupled with the placement of bone graft. This fusion helps to provide increased spinal stability.