- Anatomy of The Spine
- Back Pain in Children
- Caring for your Spine
- Emerging Spinecare Trends
- Evaluation of Spinal Disorders
- Exercise and The Spine
- Intervention - Spinal Disorders
- Intervertebral Disc
- Non Surgical Options
- Nutrition and Spinecare
- Options for Spine Treatments
- Pregnancy and Back Pain
- Prevalence of Spine Disorders
- Sleep and the Spine
- Spinecare Introduction
- Spinehealth and Disease
- Surgical Interventions
- Treatment with Medications
- Understanding Back Pain
Spinecare Topics
Intervertebral Disc
Degenerative Disc Disease (DDD)
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Degenerative Disc Disease (DDD)
One of the primary causes of disc degeneration is felt to be the result of a loss of efficient nutrient supply to cells within the disc. Like all other cell types, the cells of the intervertebral disc require nutrients such as glucose and oxygen to remain alive and active. The cells actively influence the chemical and structural environment around them. There are very few cells with the discs when compared to other tissues. This is why even subtle changes in the delivery of nutrients can adversely affect the cells and the structure of the disc. Reduced nutrient availability within the disc causes the disc to become more acidic, a state that interferes with the cells ability to function properly for the disc leading to disc degeneration.
As a disc undergoes degenerative changes, it tends to lose volume. This is characterized on X-rays as well as MRI by a loss of vertical height. The approximation of vertebral bodies contributes to approximation of the facet joint surfaces. This process can lead to increased risk for nerve impingement, inflammation, as well as joint pain. The pain associated with degenerative disc disease is often mechanical in nature, characterized by increased pain intensity with movement such as extension, flexion, rotation and/or lifting.
The diagnosis of degenerative disease is generally made by diagnostic imaging studies. Spinal X-rays are the most common diagnostic imaging procedure for diagnosis of degenerative disc disease. MRI evaluation can be used to confirm the diagnosis. MRI provides imaging of soft tissue detail and therefore reveals the loss of water content in the disc.
Degenerative disc disease typically does not require surgical intervention. The approach for a symptomatic DDD is typically conservative involving the use of clinical nutrition, spinal manipulation, physical therapy, oral anti-inflammatory medication, exercise, intervention, and less often, epidural steroid injections. Many patients have reported favorable response to chiropractic care, which incorporates most of the non-pharmaceutical and surgical options. When symptoms are unremitting and compromising quality of life and has not responded to conservative care, surgery may be a reasonable option. Fusion tends to be the standard surgical approach for the treatment of mechanical lower back pain and/or mechanically induced nerve damage with pain. Fusion of a spinal segment reduces the risk for progressive approximation of vertebral bodies due to the loss of disc volume.
Unfortunately, when one or more disc levels or vertebral levels are surgically fused, the adjacent unfused segments are placed under additional physical stress and strain in order to compensate the loss of mobility of the fused site. This can lead to a domino-like effect with complications arising at these adjacent segments. The artificial disc will become more readily available to restore some movement and to restore disc height thus increasing the openings of the neuroforamen and unloading the facet joints. The use of an artificial disc will help improve spine segment stability and function rather than acting as a fusion of the segment.
As a disc undergoes degenerative changes, it tends to lose volume. This is characterized on X-rays as well as MRI by a loss of vertical height. The approximation of vertebral bodies contributes to approximation of the facet joint surfaces. This process can lead to increased risk for nerve impingement, inflammation, as well as joint pain. The pain associated with degenerative disc disease is often mechanical in nature, characterized by increased pain intensity with movement such as extension, flexion, rotation and/or lifting.
The diagnosis of degenerative disease is generally made by diagnostic imaging studies. Spinal X-rays are the most common diagnostic imaging procedure for diagnosis of degenerative disc disease. MRI evaluation can be used to confirm the diagnosis. MRI provides imaging of soft tissue detail and therefore reveals the loss of water content in the disc.
Degenerative disc disease typically does not require surgical intervention. The approach for a symptomatic DDD is typically conservative involving the use of clinical nutrition, spinal manipulation, physical therapy, oral anti-inflammatory medication, exercise, intervention, and less often, epidural steroid injections. Many patients have reported favorable response to chiropractic care, which incorporates most of the non-pharmaceutical and surgical options. When symptoms are unremitting and compromising quality of life and has not responded to conservative care, surgery may be a reasonable option. Fusion tends to be the standard surgical approach for the treatment of mechanical lower back pain and/or mechanically induced nerve damage with pain. Fusion of a spinal segment reduces the risk for progressive approximation of vertebral bodies due to the loss of disc volume.
Unfortunately, when one or more disc levels or vertebral levels are surgically fused, the adjacent unfused segments are placed under additional physical stress and strain in order to compensate the loss of mobility of the fused site. This can lead to a domino-like effect with complications arising at these adjacent segments. The artificial disc will become more readily available to restore some movement and to restore disc height thus increasing the openings of the neuroforamen and unloading the facet joints. The use of an artificial disc will help improve spine segment stability and function rather than acting as a fusion of the segment.
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