Degenerative disc disease (DDD)

Degenerative disk disease (DDD) of the spine is the degeneration of the intervertebral disc. It is one of the most common causes of low back pain. While disc degeneration is a normal part of aging and for most people is not a problem, for certain individuals a degenerated disc can cause severe constant chronic pain and can greatly affect the quality of one's life.

This condition is not strictly degenerative and is not really a disease. The term "degenerative" applies to the disc degenerating, and not to the symptoms.

If you have chronic back or neck pain, you may have degenerative disc disease. It commonly occurs in your low back (lumbar spine) or neck (cervical spine).

DDD is a gradual process and there are many stages and states your discs can go through as part of degeneration. Discs may bulge, herniate, thin, or form osteophytes (bone spurs).

Causes

Trauma micro or macro as a simple lifting accident is the most common cause of disc degeneration. After trauma the discs in the spine dehydrate, or dry out, and lose their ability to act as shock absorbers between the vertebrae. There is minimal blood supply to the discs so they lack the ability to heal or repair themselves.

Symptoms

•  Chronic low back pain
•  Pain in the hips or thighs while walking
•  Sporadic tingling or weakness through the knees
•  Pain while sitting, bending, lifting, and twisting
•  Chronic pain in the neck or the upper spine or pain in the shoulders, arms and hands

Treatment Options

Often, degenerative disc disease can be successfully treated without surgery. One or a combination of treatments such as physical therapy, chiropractic manipulative therapy (CMT), osteopathic manipulation, anti-inflammatory medications such as nonsteroidal anti-inflammatory drugs, chiropractic treatments, Traction (orthopedics), or spinal injections often provide adequate relief of these troubling symptoms.

Surgery may be recommended if the conservative treatment options do not provide relief within 2 to 3 months. There are many surgical options for the treatment of degenerative disc disease. The most common surgical treatments include:

•  Anterior Cervical Discectomy and Spinal Fusion: A procedure that reaches the cervical spine (neck) through a small incision in the front of the neck. The intervertebral disc is removed and replaced with a small plug of bone or other graft substitute, and in time, that will fuse the vertebrae.
•  Cervical Corpectomy: A procedure that removes a portion of the vertebra and adjacent intervertebral discs to allow for decompression of the cervical spinal cord and spinal nerves. A bone graft, and in some cases a metal plate and screws, is used to stabilize the spine.
•  Facetectomy: A procedure that removes a part of the facet (a bony structure in the spinal canal) to increase the space.
•  Foraminotomy: A procedure that enlarges the foramen (the area where the nerve roots exit the spinal canal) to increase the size of the nerve pathway. This surgery can be done alone or with a laminotomy.
•  Laminoplasty: A procedure that reaches the cervical spine (neck) from the back of the neck. The spinal canal is then reconstructed to make more room for the spinal cord.
•  Laminotomy: A procedure that removes only a small portion of the lamina (a part of the vertebra) to relieve pressure on the nerve roots.
•  Micro-discectomy: A procedure that removes a disc through a very small incision using a microscope.
Percutaneous Disc Decompression: A procedure that reduces or eliminates a small portion of the bulging disc through a needle inserted into the disc, minimally invasive.
•  Spinal Laminectomy: A procedure for treating spinal stenosis by relieving pressure on the spinal cord. A part of the lamina (a part of the vertebra) is removed or trimmed to widen the spinal canal and create more space for the spinal nerves.

Further reading

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Cost of spine surgery to treat degenerative disc disease (DDD) abroad
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