When you come to the University of Michigan Health Comprehensive Spine Program for degenerative disc disease, you’ll be evaluated by our multidisciplinary team of specialists who will work with you to determine a personalized treatment plan. Our goal is to offer the most advanced and least invasive treatment to help improve your quality of life.
What is Degenerative Disc Disease?
Degenerative disc disease refers to changes in the discs in the spine, most often due to the aging process or to a spinal injury. Spinal discs are soft, compressible discs that separate the spine’s interlocking bones, or vertebrae. These discs serve as shock absorbers that enable the spine to bend and twist.
While degenerative disc disease can happen anywhere in the spine, it typically affects the lumbar (lower back) region or the cervical (neck) region. Degenerative disc disease can also affect the thoracic (middle) region of the spine.
Changes in the discs can cause back or neck pain as well as other issues, including:
- Osteoarthritis, a type of arthritis associated with aging in which cartilage that protects and cushions joints breaks down.
- Spinal stenosis, the narrowing of the spinal canal, the open space in the spine that holds the spinal cord.
For many individuals, degenerative disc disease may not cause any symptoms. Others, however, may experience back or neck pain and stiffness. The location of your pain depends on the affected disc:
- A degenerative disc in the neck area may result in neck or arm pain or numbness.
- A degenerative disc in the lower back may result in pain or numbness in the back, buttock or leg, difficulty walking and lack of balance or coordination.
- Occasionally, bowel and bladder control problems may occur with spinal cord stenosis or significant nerve compression.
Our collaborative team begins by conducting a complete medical history and physical exam as well as a review of any symptoms, injuries or illnesses, previous treatment, or habits and activities that could be responsible for your pain.
Testing is done using the most advanced technologies and may include: Imaging such as X-rays, CT scans or MRI of the affected area. An EMG to assess the electrical activity of the nerves and muscles. A discogram to evaluate back pain and help determine whether the degenerated disc is the cause of pain.
After your diagnostic tests are completed, our specialists will talk with you about your treatment options.
Most cases of degenerative disc disease can be managed without surgery through our comprehensive pain program focused on interventional therapies. Non-surgical treatment is based on symptoms and is aimed at reducing pain and improving function. Treatment may include:
- Physical therapy and exercises to help strengthen specific muscles to help the back heal and reduce the frequency of painful flare-ups.
- Pain management, including anti-inflammatory and pain medications, muscle relaxers, manual manipulation, steroid injections, electrical stimulation, radiofrequency ablation and heat/ice therapy.
- Traditional medicine combined with holistic therapies such as yoga, healing touch and acupuncture.
When symptoms related to disc degeneration don't improve with conservative treatment or if there is a progression of neurologic symptoms, surgery may be recommended. The goal of surgery is to relieve pressure on the nerves and stabilize the degenerated disc(s). Our spine specialists are skilled in the use of minimally invasive techniques that incorporate advanced navigation and robotics procedures, leading to faster recovery, less discomfort and shorter hospitalizations.
Treatment options include:
- Laminectomy: Removal of fragments of bone and soft tissue if spinal stenosis or significant nerve compression are involved. Depending on certain factors, this may be performed as a minimally invasive procedure or an open procedure. For more severe cases in which there is significant nerve compression, a laminectomy may be combined with a spinal fusion.
- Spinal Fusion: A procedure that reduces the movement in the damaged spine segment by permanently connecting two or more vertebrae using screws and rods to stabilize the spine. A bone graft is also typically performed using additional bone to fill in gaps between the vertebrae and stimulate the healing process.
- L5-S1 Anterior Lumbar Interbody Fusion: A procedure performed in the lower spine (typically L4-L5 or L5-S1) in which the disc is removed and a cage/interbody fusion is placed between the discs to help restore disc height and indirectly decompress the affected nerve(s). This procedure is performed through the abdomen versus the back, resulting in a smaller incision and quicker healing.
You're about to make an important decision, and we want to help you make a good one. Our staff will be glad to talk with you about your options and how we can help. Please visit our Make an Appointment page for more information.