Lumbar degenerative disc disease is a chronic (ongoing) degenerative condition of the lumbar spine that affects the vertebral bodies and intervertebral discs of the low back. The discs lose water content and shrink, and spurs often form as osteoarthritis develops.
Lumbar degenerative disc disease is quite common and progresses with age. The condition can cause lumbar spinal stenosis.
Many people do not have symptoms, but symptoms can occur at any time. Typical symptoms include pain or stiffness of the back.
If the canal around the nerves narrows, patients can experience:
- Back pain
- Leg pain
- Numbness, tingling or weakness of the legs
- Difficulty with walking and lack of balance or coordination
- Occasionally, bowel and bladder control problems may occur
- A medical history will be taken and a physical exam will be conducted.
- Imaging can include X-rays, CT scans or MRI of the low back.
- An EMG (nerve study) may be ordered.
- Discography to identify the degenerated disc as the cause of pain
Treatment is based on symptoms, and is aimed at reducing pain and improving function. Treatment may include:
- Physical therapy for strengthening the muscles
- Non-steroidal anti-inflammatory medications (NSAIDs) to lessen symptoms
When symptoms don't go away:
- Muscle relaxants
- Steroid injection into the affected area
When symptoms don't improve with conservative treatment or if there is a progression of neurologic symptoms, surgery may be recommended.
Surgery often involves a fusion. A fusion stops the motion at the level the surgery is being done. Screws and rods are placed and, occasionally, a bone graft is done. The surgery is often performed from the back, but in some circumstances can be done from the front.
Most patients are hospitalized about 4 days. A brace may be worn during the healing process. Recovery is generally about 3 to 6 months.
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