Lumbar Degenerative Disc Disease

Discs are normally soft and cushion the spine during stress. Degeneration of these discs is characterized by a decrease in water content, loss of height, and frequently protrusion from the disc space into spaces normally occupied by the nerves and spinal cord. Disc degeneration is often associated with spinal instability, and bone spurs may subsequently grow in an attempt to stabilize the spine.

Causes

Lumbar Degenerative Disc disease can be caused by fissuring of the annulus fibrosus, a ligamentous-like structure that encapsules the disc.  This can result from torsional strain, overuse, or an acute disc herniation.  Certain motions can place a high amount of pressure on the disc.  Disc material can protrude or extrude and the disc material is very inflammatory, causing pain.  Furthermore, disc contents can irritate nearby nerves.

Symptoms

Symptoms include back pain, possibly with radiation into the lower extremities depending on the type of disc injury/degeneration.  Symptoms frequently overlap with lumbar stenosis or herniated disc.

Treatment

Procedural treatment for disc disease can include cortisone injections under imaging guidance via a transforaminal or interlaminar approach.  The location of the injection is decided by the distribution of symptoms and imaging findings.  Regenerative injections including platelet-rich plasma (PRP) injections are also being used experimentally to provide a healthier environment to promote healing in the region.  Some physicians will inject material into the disc itself.

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