Christopher P. Silveri, M.D.

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StoneSprings Hospital Location
24430 Stone Springs Blvd.
Suite 250
Dulles, Va 20166

Tel: 703 391 0111

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Degenerative Spine

Degenerative spinal conditions are a group of disorders that cause the loss of the normal structure and function of the spine. These disorders may be caused due to aging, infection, tumors, muscle strains or arthritis. Degenerative joint disease is commonly known as arthritis, and affects feet, fingers, hands, spine and weight-bearing joints. It is caused due to the inflammation of joints because the articular cartilage covering the bones may be damaged or worn out.

Degenerative disc disease refers to the gradual deterioration of the disc between the vertebrae.

Causes

As people age, intervertebral discs lose their flexibility, elasticity and shock absorbing characteristics. Annulus fibrosis, the outer fibers surrounding the disc, becomes brittle and can tear more easily. At the same time, nucleus pulposus the soft gel-like substance located in the center of a disc starts to dry out and shrink.

Symptoms

Every patient is different, and it is important to realize that not everyone develops symptoms as a result of degenerative disc disease. When the condition becomes painful or symptomatic, it can cause several different symptoms due to the compression of the nerve roots. Depending on the location of degenerative disc, it could cause back pain, radiating leg pain, neck pain, and radiating arm pain.

As the discs between the intervertebral bodies start to wear out, the entire lumbar spine becomes less flexible, resulting in back pain and stiffness.

Diagnosis

The diagnosis of degenerative disc disease begins with the patient’s history and a complete physical examination. Examination of the back is performed for flexibility, range of motion, and the presence of certain signs, which suggest that nerve roots are being affected by degenerative changes in your back. This is done by testing the strength of your muscles and your reflexes, to make sure that they are still working normally.

A series of X-rays is also usually ordered. If degenerative disc disease is present, the X-rays will often show a narrowing of the spaces between the vertebral bodies, which indicates the disc has become very thin or has collapsed. Bone spurs formed around the edges of the vertebral bodies and around the edges of the facet joints in the spine can be seen on an X-ray. As a result, the spaces available for the nerve roots start to shrink. The nerve roots exit the spinal canal through a bony tunnel called the neural foramen and it is at this point that the nerve roots are especially vulnerable to compression.

In most cases a MRI or a CT scan may be ordered to evaluate the degenerative changes, determine disc herniation and nerve root compression. A CT scan is often used to evaluate the anatomy in the spine which can show how much space is available for the nerve roots within the neural foramina and spinal canal.

Treatment

Both surgical and nonsurgical treatment options are available for degenerative conditions. The choice depends on various factors such age of patient and severity of disease.

Nonsurgical treatment – For people with no evidence of nerve root compression or muscle weakness, conservative treatment such as medication, rest, exercise and physical therapy are typically recommended.

Surgical treatment – Surgery is offered only after conservative treatment options failed to adequately relieve the symptoms of pain, numbness and weakness over a significant period of time. Decompression of the spinal cord, accompanied by a discectomy or an anterior cervical discectomy and fusion, will be performed to remove the affected disc and fuse the associated vertebrae in order to stabilize the spine in that area.

  • North American Spine Society
  • INOVA Fair Oaks Hospital
  • American Academy of Orthopaedic Surgeons
  • American Board of Orthopaedic Surgery
  • Inova Health System
  • Pennsylvania Hospital