Degenerative Disc Disease
Degenerative disc disease is a weakening of one or more vertebral discs, which normally act as a cushion between the vertebrae. This condition can develop as a natural part of the aging process, but it may also result from a trauma to the disc that did not necessarily cause serious pain at the time of the injury. Day to day stresses and minor injuries can add up over time and begin to affect the discs in your spine. As a disc begins to suffer from the wear and tear of life, it begins to degenerate.
Shock Absorber of the Spine
A healthy disc has a great deal of water in the nucleus pulposus (the center portion of the disc). This water content gives the nucleus a spongy quality and allows it to absorb spinal stress. This pulpy material is surrounded the annulus, an outer ring of tough ligament material, that holds the vertebrae together.
Disc Wall Tears & Heals
Degenerative disc disease typically begins when small tears appear in the disc wall. These tears in the annulus can cause pain. When the tears heal, scar tissue is created. However, this scar tissue is not as strong as the original disc wall. If the back is repeatedly injured, the process of tearing and scarring may continue, and the annulus becomes weaker over time.
Disc Center Weakens
Over time, the center of the disc, called the nucleus, becomes damaged and loses some of its water content. This center is called the pulposus, and its water content is needed to keep the disc functioning as a shock absorber for the spine, or to bend and twist.
As the nucleus continues to lose water content, the disc begins to collapse. The vertebrae above and below this damaged disc slide closer together. This improper alignment causes the facet joints – the areas where the vertebral bones touch – to twist into an unnatural position. Shifting changes the way the facet joints work together and can cause other spinal problems as well.
Bone Spurs Form
In time, this awkward positioning of the vertebrae may create bone spurs, sometimes called osteophytes. This is thought to be due to the body’s response to try to stop the excess motion at the spinal segment. If these spurs grow into the spinal canal, they may press into the spinal cord and nerves. This painful condition is called spinal stenosis.
Symptoms of Degenerative Disc Disease
Some people with degenerative disc disease experience pain, numbness or tingling in the legs. Intense periods of pain may come and go. Bending, twisting and sitting may make the pain worse. Lying down often relieves pressure on the spine.
Causes of Degenerative Disc Disease
Although there is a slight genetic component to individuals who suffer from DDD, the true cause probably stems from multiple factors. It could be from simple wear and tear, or may have a traumatic cause. However, it rarely starts from a major trauma such as a car accident. It is most likely due to a low energy injury to the disc that progresses with time.
Diagnosing Degenerative Disc Disease
To diagnose degenerative disc disease, you may need to have some imaging tests. You may have an x-ray, which can help your surgeon “see” the bones in your spine. X-rays are effective at showing narrowed spinal channels (spinal stenosis), fractures, bone spurs (osteophytes), or osteoarthritis.
Minimally Invasive Surgical Techniques
The good news is that usually the pain from DDD settles itself without the need for surgery. However, if surgery is required, minimally invasive surgery offers a number of advantages over traditional “open” spine surgery. A minimally invasive procedure uses a very small incision, sometimes only ½ inch in length. The minimally invasive spine surgeon inserts special surgical instruments through the tiny incisions to access the damaged disc. Unlike traditional, “open” spine surgery, entry and repair to the damaged disc or vertebrae is achieved without harming nearby muscles and tissues. Less muscle and tissue damage results in less pain and a faster recovery of the patient.
If surgery is necessary, it will likely be one of the following minimally invasive procedures:
Minimally Invasive Discectomy
If the disc tears or bursts, sometimes the soft portion in the middle squirts out to put pressure on the nerves surrounding it. This is called a “herniated disc”. This can cause pain in the buttocks or thighs, commonly known as sciatica. A Discectomy is the process of removing the burst disc that is causing the pain.
Minimally Invasive Laminectomy
Sometimes pressure, often caused by overgrowth of the facet joints related to arthritis, can cause pain in the spine. A Laminectomy removes the back portion of vertebra—the lamina—and creates more space, relieving pressure on the spine or nerves.
Minimally Invasive Fusion
This surgery usually involves making a small incision through the patient’s back. With a Minimally Invasive Fusion, the ruptured disc is removed to alleviate pressure and then we use metal screws, rods and bone grafts to fuse the spine. With some patients, it’s necessary to fuse the spine through the abdomen and others will need surgery both through the front and the back.
Cervical Total Disc Replacement
Using this procedure, we remove the damaged disc and replace it with an artificial disc. A Cervical Total Disc Replacement is similar to that of spinal fusion, but, instead of fusing the spine, a metal disc is inserted and attached to the vertebra above and below the damaged disc. This allows for normal range of motion of the cervical spine, and takes the pressure off of the discs above and below.
Advanced Techniques, Faster Recovery
Minimally invasive surgery for degenerative disc disease includes numerous advanced techniques and technologies compared to traditional spine surgery. DISC of Louisiana is a locally owned Orthopaedic Spine Group specializing in the treatment of degenerative disc disease, as well as a wide range of other spinal conditions. Dr. Shamieh and Dr. James specialize in the latest minimally invasive spinal procedures before unavailable here in south Louisiana.
If you have questions about spinal stenosis or the minimally invasive spine procedures offered by DISC of Louisiana, please contact us to schedule an evaluation at one of our clinics across the south Louisiana region.
DISC of Louisiana Locations
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