Degenerative disc disease occurs when spinal discs degenerate, or wear down. The discs of the spine cushion the interlocking vertebrae and act as shock absorbers for the back, allowing it to bend, flex and twist. They break down over time as a natural part of the aging process.
Spinal discs are composed of two layers – a tough, firm outer layer and a soft, jelly-like core. Small tears in the outer layer may cause the soft material in the center to leak out, causing a disc to bulge or rupture. This is a leading cause of back pain, primarily in the lower back and the neck. However, not everyone who has degenerative disc disease experiences pain.
At UPMC, we begin with conservative treatments such as medications and physical therapy to alleviate pain and increase mobility. Most patients experience relief from pain within a month or two with conservative treatment. When these treatments fail to provide relief, our neurosurgical team may recommend surgery such as artificial disc replacement or spinal fusion.
The doctor will perform a physical exam and ask the patient about his or her symptoms, previous injury, illness, and physical activities that may be causing pain. The doctor may test range of motion in the affected area and look for tender spots, numbness, weakness, tingling, or changes in reflexes.
Symptoms may include:
If degenerative disc disease is suspected, an MRI can confirm the diagnosis and rule out other potential causes of symptoms. The doctor may also order a discography or x-ray. A discography is an imaging test in which dye is injected into the affected spinal area to get clearer x-ray images.
At UPMC, we focus on treating the primary symptom of degenerative disc disease. Ice and non-steroidal anti-inflammatory drugs (NSAIDS) can reduce swelling and alleviate pain. If the damaged disc has resulted from other conditions, such as osteoarthritis, a herniated disc, or spinal stenosis, physical therapy and back strengthening and stretching are often prescribed.
Surgery may be considered when patients do not respond to conservative treatment and are severely limited in performing activities of daily life. At UPMC, our neurosurgeons specialize in minimally invasive surgical procedures that typically allow for a faster recovery.
Spinal fusion can reduce pain by stopping the motion at a painful segment of the spine. The disc is removed from between two vertebrae, then the vertebrae are fused together. This procedure is performed through a single incision in the back.
Another surgical option is artificial disc replacement. Replacing the disc instead of fusing the vertebrae together may allow for more normal motion in the spine. This reduces the chance that other segments of the spine will break down due to increased stress.
Minimally Invasive Spine Surgery
Dr. Adam Kanter describes the advantages of minimally invasive spine surgery.