Jason E. Smith MD
Spine Surgeon with Baton Rouge Orthopaedic Clinic
Call Us: 225-924-2424
What Is Degenerative Disc Disease (DDD)?
Degenerative disc disease (DDD) is part of the natural process of growing older. As we age, our intervertebral discs lose their fluid or flexibility, elasticity, and shock absorbing characteristics. The outer fibers that surround the disc, called the annulus fibrosis, become brittle and can more easily be torn. At the same time, the soft gel-like center of the disc, called the nucleus pulposus, starts to dry out and shrink. The combination of damage to the intervertebral discs, the development of bone spurs and the gradual thickening of the ligaments that support the spine can all contribute to degenerative arthritis of the lumbar spine.
To a certain degree, this process happens to everyone. However, not everyone who has degenerative changes in their lumbar spine has pain. Many people who have outwardly appear to have normal backs have MRIs that show disc herniations, degenerative changes, and narrowed spinal canals. Every patient is different, and it is important to realize that not everyone develops symptoms as a result of degenerative disc disease.
What Are The Symptoms Of Degenerative Disc Disease?
When degenerative disc disease becomes painful or symptomatic, it can cause several different symptoms due to the compression of the nerve roots. Depending on where your degenerative disc is located, it could cause:
Radiating arm pain
Radiating leg pain
These symptoms are caused by the fact that worn out discs are a source of pain because they do not function as well as they once did, and as they shrink, the space available for the nerve roots also shrinks. As the discs between the intervertebral bodies start to wear out, the entire lumbar spine becomes less flexible. The result can be back pain and stiffness, especially towards the end of the day.
How Is Degenerative Disc Disease Diagnosed?
The diagnosis of degenerative disc disease begins with a complete physical examination.
Key points of the physical exam:
A series of x-rays is usually ordered for a patient with back pain. If degenerative disc disease is present, the x-rays will often show some of the following:
As the disc collapses and bone spurs form, the space available for the nerve roots starts 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 many situations, doctors will order a MRI or a CT scan (CAT scan) to evaluate the degenerative changes in the lumbar spine more completely. A MRI is very useful for determining where disc herniations have occurred and where the nerve roots are being compressed. A CT scan is often used to evaluate the bony anatomy in the spine, which can show how much space is available for the nerve roots within the neural foramen and spinal canal.
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