Degenerative Disc Disease
As we age so does our spine. Degenerative disc disease is one of the most common causes of low back and neck pain, and also one of the most misunderstood. Degenerative disc disease in the lumbar spine, or lower back refers to a condition where one or more of your discs becomes dehydrated and deteriorated and begins to causes low back pain. In some people this condition can be genetically related, but in most it is related to multiple factors. Our vertebrae and disc can simply wear down and develop micro tears in the outer wall of the disc called the annulus. Sometimes theses conditions can also result from a trauma such as an accident or excessive lifting of heavy objects.
The discs in our spine do not have a blood supply, so when they do sustain a traumatic injury they do not repair themselves. Sometimes insignificant insult or injury to the disc can start a degenerative cascade that begins to wear out the disc. Degenerative disc disease is fairly common and estimated to affect 30% of people aged 30-50 years of age. Not all people with degenerative disc disease will suffer from pain or be diagnosed formally. In fact people of 60 years of age are expected to have some level of disc degeneration and is normal findings on an MRI scan.
Annular Tears or Disc Tears
With trauma, degeneration begins and the outer layers of the disc may tear (Annular Tear) and may expose the spinal nerve and exiting nerve to the inner nucleus pulposus. It is believed that nucleus pulposus can irritate one or both of the nerves and thus produce a great deal of pain. If the annular tear becomes large enough the disc may extrude or herniate through the tear resulting in a disc herniation. Annular tears can be diagnosed with a history of pain and can be observed on an MRI as a white, high intensity zone on the posterior disc. Discogenic pain is the term used to describe pain resulting from annular tears.
Annular Tear Symptoms
When DDD and annular tears become prevalent the following symptoms are associated with this condition:
- Pain in the area of the tear in the low back. This pain can travel into the buttocks and thighs not usually past the patient’s knees.
- Numbness and or tightness can be related to disc tears or bulging disc and herniated disc. If the disc bulges, extrude or herniates into the spinal canal and compresses the spinal nerves the patient can experience numbness in the arms or legs.
- Weakness is very common associated symptom resulting from a spinal nerve being compressed. The patient experiences weakness in their arm losing their hand grip or legs buckle and they lose control of the leg temporarily.
- Tingling is commonly found in patient’s hands or feet when experiencing degenerative disc disease, annular tears or herniated disc.
Provided that no disc herniation is observed annular tears can usually be treated successfully with conservative treatments such as:
- Hot or cold compresses
- Exercise and activity modifications
- Non-steroidal anti-inflammatory pain medicines
- Massage and physical therapy
- Transcutaneous electrical nerve stimulation
- Epidural steroid injections
Once conservative measures have been exhausted and after 6 months the patient is still in considerable pain, Open Endoscopically Assisted Tubular Retractor Surgery can be helpful. The following procedure has shown great results in minimizing in most cases and alleviating pain altogether in some cases:
- A ¼ inch incision is made and a 7mm operating tube is place into the disc at the site of the annular tear. An endoscope with HD camera is inserted into the operating tube to visualize the annulus and spinal nerves. Then the tear is debrided to make sure no nucleus pulposus is stuck within the annulus and thermally heated with bipolar instrument to reduce and close the tear.
The Jasper Spine Institute Interventional Pain Management Advantage:
- Less than ¼ inch incision
- Less post-operative pain and recovery than traditional minimally invasive procedures
- Outpatient procedure with patients discharged within 2 hours of surgery
- Return to work within 3-5 days*
At Jasper Spine Institute we listen and work with you to develop a unique treatment regime that addresses your pain and symptoms. Our goal is always to provide solutions whether conservative or surgical so that you are able to return to the quality of life you want without the pain and suffering.
* Always seek your physician’s opinion when it is safe to return to work. Also, light administrative duty is recommended until your physician approves of any physical demands at your place of work.