Degenerative Disc Disease

Degenerative = relating to deterioration over time*

Disc = one of the disk-shaped cushions between the bones of the spinal cord

Disease = a specific problem with a body or body part

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* (Note that the word “degenerative” in “degenerative disc disease” doesn’t mean that the pain will keep getting worse over time. That is, the “disease” itself is not degenerative. Instead, “degenerative” describes the cause of the changes in the spinal discs. The changes in the spinal discs are due to wear and tear over time—not to trauma, infection, or some other cause.)

The vertebral column (backbone) is made up of 33 vertebrae. These vertebrae are grouped into divisions called the cervical (neck), thoracic (upper back), and lumbar (lower back). Each pair of vertebrae are connected by an intervertebral disc–a fibrous disc with a softer cartilage core. In a healthy spine, these intervertebral discs cushion the vertebrae and permit normal flexibility of the spine.

As people age, however, the discs undergo changes. They may dry out, thin, or crack. The soft cartilage core may bulge or herniate out through the fibrous outer portion of the disc. Degenerative disc disease is an umbrella term that describes these age-related processes.

Most people’s spinal discs degenerate over time. By the age of 35, approximately 30% of people will show evidence of disc degeneration at one or more levels. By the age of 60, more than 90% of people will show evidence of some disc degeneration. Degeneration itself is normal, and does not necessarily cause pain. Painless degeneration is just called degeneration. The term “degenerative disc disease” describes disc degeneration that causes pain and other symptoms.

 

 

Symptoms

Degenerative disc disease can cause pain, weakness, or numbness. Exact symptoms vary depending on the location and type of disc degeneration. However, the primary symptoms of degenerative disc disease include sharp and/or chronic pain in the back and neck.

As the discs undergo change, the body may react and develop bony growths called bone spurs. In severe cases, these bone spurs may take up room needed by the spinal cord and surrounding nerves to move freely in the spinal canal. If the nerves in the spine become compressed (pinched), patients may experience weakness in the arms or legs and numbness in the legs. Compression of the spinal cord itself is referred to as myelopathy. A patient with myelopathy may have difficulty walking, and may even experience loss of bladder and bowel control.

Diagnosis

If a patient presents with symptoms associated with degenerative disc disease, the surgeon may order the following tests:

• X-rays: although X-rays cannot show soft tissue like discs, they provide details of the bone structures in the spine.

• Magnetic resonance (MR) imaging: this type of scan provides a detailed image of discs, allowing surgeons to see how the nerves and spinal canal space are affected by degenerative disc disease.

• Computed tomography (CT) scan: provides a detailed image of bone structures in the spine and is a great option for those patients who cannot undergo MR scans (for example, those who have a pacemaker or who have specific types of metallic implants)

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