Intervertebral discs can be thought of as spongey cushions, because they act as shock absorbers between the vertebrae, which allows the back to be flexible. However, as a result of wear and tear over time, or due to certain diseases, these discs can begin to wear out and degenerate. At Instituto Clavel, we would like to help you understand this pathology which can cause a person so much pain that it interferes with performing normal daily activities.
Let’s take the example of Michael. Michael is a 25-year-old athlete with a young, healthy spine. The 24 vertebrae that make up the human spine are linked by intervertebral discs that provide the flexibility needed to train in the gym, as well as to perform routine daily activities.
However, by the time Michael reaches the age of 65, it is likely that his discs will have begun to lose their water content, which means that they lose height, reducing the space between the vertebra. When this happens, the discs can no longer cushion the impacts, and as a result, the openings of the spinal nerves become narrower, which can lead to sciatica caused by compression of the nerves.
As we said, one of the most common causes of degenerative disc disease is the natural aging process, and, in addition, it can appear as a result of a back injury. In general, the symptoms of degenerative disc disease are as follows:
- Neck pain
- Back or leg pain
- Tingling or numbness in the legs or buttocks
- Difficulty walking
Stages of degenerative disc disease
To diagnose degenerative disc disease, the specialist will start with a physical examination, and a review of the patient’s clinical history, including the patient’s description of the symptoms and the circumstances in which the pain began.
Following that, if the doctor concludes that it could be discogenic low back pain, the next step will be to use magnetic resonance imaging (MRI) to determine the stage of degenerative disc disease. Here we list the various stages:
- Normal
- Congenital/developmental variant
- Degenerative changes
Much less frequently:
- Injury
- Inflammation/Infection
- Neoplasm (abnormal mass of tissue)
- Miscellaneous (peridiscal masses of uncertain significance)
The types of degenerative changes that can be observed in a disc are usually classified as follows:
- Annular fissure: the separation of the fibers of the fibrous ring that surrounds the nucleus pulposus of the intervertebral disc.
- Degeneration: this includes all the terms that denote dehydration, fibrosis, decreased intervertebral space, among others.
- Hernia: Hernias can be classified as protrusion or extrusion. Protrusion indicates that the distance between the edges of the disc herniation is less than the distance between the edges of the base. Extrusion is present when the distance between the edges of the disc material is greater than the distance at the base.
Contrary to popular belief, the spine begins to show degenerative changes from the age of 30 onwards. Therefore, it is not a necessarily an old person’s condition, because it can also appear at an early age. This is due to a complex series of factors: genetic, structural, environmental, microtrauma and aging.
Treatment Options for Degenerative Disc Disease
The primary objective of the treatments for this pathology is to control the pain, and this is where exercise can be a key element in helping you achieve this goal. Physical exercise can help you increase strength and flexibility, as well as blood circulation in your back, nourishing your joints and muscles with oxygen.
At Instituto Clavel we can recommend the exercises that best suit your lifestyle. Remember, it is always a good idea to check with a specialist for medical advice first before beginning any new exercise routine, and especially if you have been diagnosed with a spinal pathology or suffer from disc degeneration.
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Lumbar degenerative disc disease
Most people who suffer from the wear and tear of the discs in the lumbar spine find relief without surgery, for example, with exercise as mentioned above. However, if surgery is required, here are some of the main options:
1. Lumbar microdiscectomy: this surgical technique allows removal of the damaged tissue of the lumbar disc to release the compressed nerve roots. It is carried out with the use of a special microscope, which magnifies the image so that only a minimal incision is required. This decreases damage to surrounding tissues and recovery is faster.
Find out more about this surgery
2. Artificial Disc Replacement: In this surgery, an artificial disc is inserted to replace the damaged disc, allowing the patient to regain normal movement and flexibility. In this article on our website you can find more information about ADR surgery, the procedure through which a degenerated lumbar disc is replaced by an artificial implant.
Cervical degenerative disc disease
All the procedures we perform at Instituto Clavel are intended to attack the root of the problem. When we are presented with a case involving degenerative disc pathology, it is treated principally according to the type of degeneration and its symptoms.
What are the main treatments we offer for cervical degenerative disc disease?
- Anterior cervical fusion (ACDF): A procedure used to treat compression of the nerve root or spinal cord. In some cases, this is accompanied by placement of an anterior cervical plate fixed with screws.
What is microdiscectomy for cervical fusion?
- Anterior cervical disc arthroplasty (ACDA): The goal of this procedure is to decompress the structures of the spinal canal compressed by a herniated disc, for example, with the aim of restoring the mobility of the segment rather than stabilizing it with plates and screws. In this case, as in lumbar degenerative disc disease, an ADR surgery is performed to place a prosthesis to replace the degenerated cervical disc.
- Anterior cervical corpectomy (indicated only in cases of severe degeneration or tumors): A segment (disc and body of the vertebra) of the cervical spine is completely removed and a cylinder is placed that fuses the vertebra above with the one below. This usually includes an anterior cervical plate.
In our practice at Instituto Clavel, we use both open surgery and minimally invasive approaches, always according to the individual case. Another detail that sets us apart is that our surgeons operate preserving and taking into account the spinopelvic parameters of the sagittal balance of the spine, that is, the balance that must be maintained between the spine and the pelvis, to ensure that the head, shoulders, and pelvis stay aligned over the feet, which is vital to avoid future complications and relapses.
Categories: Spine treatments, Spine pathologies, Cervical pain