Degenerative Disc Disease

The typical person with degenerative disc disease is active, otherwise healthy and in his or her 30s or 40s. Common symptoms of this condition include:

 

• Pain that is worse when sitting. While seated, the discs of the lower back have three times more load on them than when standing.

• Pain that gets worse when bending, lifting or twisting

• Feeling better while walking or even running than while sitting or standing for long periods of time

• Feeling better changing positions often or lying down

• Periods of severe pain that come and go. These last from a few days to a few months before getting better.  They can range from nagging pain to severe, disabling pain.

• Pain can affect the low back, buttocks and thighs or the neck, depending on where the affected disc is, radiating to the arms and hands

• Numbness and tingling in the extremities

• Weakness in the leg muscles or foot drop may be a sign that there is damage to the nerve root

 

Several factors can cause discs to degenerate, including age. Specific factors include:

 

• The drying out of the disc. When we are born, the disc is about 80% water. As we age, the disc dries out and doesn't absorb shocks as well

• Daily activities and sports cause tears in the outer core of the disc. By the age of 60, most people have some degree of disc degeneration. Not everyone at that age has back pain, however.

• Injuries, which can cause swelling, soreness and instability. This can result in low back pain.

To diagnose degenerative disc disease, the consultation begins with a medical history. During a physical exam, the doctor looks for limitations on movement, pain, loss of reflexes or other symptoms when the patient moves his or her spine. Other procedures that can help confirm the diagnosis include:

 

• X-rays, which can help rule out tumors, injuries or abnormalities

• Magnetic resonance imaging (MRI), which can be helpful in detecting damage or disease in the soft tissues, such as the discs between vertebrae or ligaments

• Computerized tomography (CT scan), which can show the shape, size and nearby structures of the spinal canal

• Myelogram, in which an opaque dye is injected into the spinal column followed by an MRI or CT scan, can show pressure on the spinal cord or nerves from herniated discs, bone spurs or tumors

• Bone scan, which can detect fractures, tumors, infections and arthritis

 

 

Here at the California Spine Institute we always consider non-surgical treatment first when managing degenerative disc disease and other neck and back ailments. Non-surgical treatment options are effective at treating the majority of neck and back disease. Some common non-surgical treatments include:

 

• Physical therapy – Often the first step in managing back and neck problems caused by osteoarthritis, we prescribe physical therapy, which improves flexibility and mobility and increases strength. Typical physical therapy treatments include exercise, massage, electrical stimulation, heat therapy, hydrotherapy (aquatic therapy) and others. The California Spine Institute has a fully equipped, state of the art physical rehabilitation center onsite.

• Chiropractic – Chiropractors typically adjust the spine in order to treat neck and back pain, deploying such techniques as manual manipulation (adjustment), applied pressure, and massage, of the vertebrae and joints. We provide a range of chiropractic services at our physical rehabilitation center.

• Pain management – Pain management covers a wide range of remedies, such treatments as injections, drugs and medications, spinal bracing and others.

• Alternative medicine – We have found that several non-traditional therapies including acupuncture, acupressure, yoga, biofeedback, and more are sometimes viable solutions for relieving back pain. Although supporting research is limited, many of our patients have reported relief from alternative medicine.

 

In addition to medical treatment, there are a variety of things you can do to delay onset and lessen the severity of spine arthritis. These include:

 

• Maintain a healthy weight

• Maintain proper posture

• Remain active and avoiding any extended periods of inactivity

• Quit smoking, as smoking impairs blood flow resulting in nutrient and oxygen loss in spinal tissues

• Wear comfortable, low-heeled shoes

• Sleep on a mattress of medium firmness to reduce curvature of the spine

If conservative, non-surgical approaches aren’t  successful, surgery may be needed, such as open back surgery to replace damaged discs. Until recently, this was a major operation that required general anesthesia, the dissection of muscle, removal of bone, manipulation of nerve roots, and, at times, bone fusion. Often, these types of procedures require large incisions and the manipulation bones and muscle tissue.

 

Conventional back surgery attempts to solve this and other back problems with extreme measures—such as removing a spinal disc or fusing parts of the spine together, so that they no longer move independent of one another, significantly decreasing the spine's mobility, or ability to move freely. Too often, considering the risks and sustained trauma, these solutions fail to relieve the patient's pain or make it and the overall spine condition worse.

 

It hurts just thinking about that. As you can imagine, major alterations like this to your spine (not to mention the huge access wound) take a long time to heal, several weeks or months. Full recovery, or returning to 100 percent original functionality, occurs infrequently. Also, this kind of surgery can require lengthy hospital stays, entails significant blood loss, and renders the patient vulnerable to several possible complications.

Minimally Invasive Spinal Surgery (MISS) is a procedure for decompressing nerve roots and other tissues affected by a degenerative disc disease, as well as several other types of back conditions. The term minimally invasive, of course, speaks volumes. It defines a category of procedures designed to do as little damage—to be as non-invasive and non-intrusive—as possible. Minimally invasive surgery, then, refers to surgical procedures designed to do as little collateral or malingering damage as possible.

 

 

 

In other words, we perform the procedure with minimal disruption to:

 

• The offending disc, joint, bone spurs, or facet area itself

• The entry point and access path

• The immediate area surrounding the problem area

• The patient’s overall health.

 

MISS is performed with micro instruments, fiber optics, lasers and digital imaging, as opposed to conventional highly invasive knives, bone saws and other equally trauma-inducing devices. Compared to conventional open back surgery, which usually entails huge incisions, displacing muscle tissue and nerve roots, and sometimes the removal of bone, MISS is without question much less traumatic. Also, it doesn’t destabilize the spine, unlike many conventional back surgeries. It can also be performed on multiple discs or other offending areas, even at widely spaced levels, during the same surgical session. Working on multiple levels with open back surgery often requires additional destructive entry wounds—far too much traumatic damage for patients to endure or recover from.

 

Degenerative disc disease—one of the more common back problems—for example, can cause pressure on the nerves in your spine, causing severe pain. Conventional back surgery attempts to solve this and other disc problems with extreme measures—such as removing a spinal disc or fusing parts of the spine together, so that they no longer move independent of one another. Either method significantly decreases the spine’s mobility, or ability to move freely. Too often, considering the risks and sustained trauma, these solutions fail to relieve the patient’s pain or make it and the overall spine condition worse.

 

As you can imagine, major alterations like this to your spine (not to mention the huge access wound) take a long time to heal, several weeks or months. Full recovery, or returning to 100 percent original functionality, occurs infrequently. Also, this kind of surgery can require lengthy hospital stays, entails significant blood loss, and renders the patient vulnerable to several possible complications.

 

MISS, on the other hand, is performed with very small “micro” instruments and tiny cameras inserted through a small tube. We also use x-ray, and other types of visualization technology to help guide the instruments, allowing us to “see” what we’re doing without cutting and clearing obstructing vital tissues and structures. We reach the offending disc through a very small incision. Damage to tissues and other vital structures in the immediate vicinity are, in nearly all instances, so minuscule that within a very short time the access point and path are healed, with little to no impact on the patient’s body and overall health.

There are numerous advantages to MISS compared to open spinal surgery, including:

 

An outpatient  or  “same day surgery“, no hospitalization

 

Less traumatic

 

Faster recovery

 

Costs less - approximately 40% less than a open spinal  surgery/fusion

 

Minimal to no scarring in and around the nerves post operatively

 

Earlier return to work and to daily activities

 

Patients can begin an exercise program the day after surgery

 

Multiple level spinal discectomy can be performed at one sitting with minimal risk

 

Can be done for high risk anaesthesia patients with morbid obesity, emphysema, and cardiac conditions under local anaesthesia/IV sedation at much less risk

 

Preserves spinal motion

 

After surgery, most patients require little analgesics

 

MISS requires no hospitalization, allows for earlier recovery and earlier return to work and return to daily activities, when compared to conventional spine surgery.

 

Please feel free to contact my staff at (800) 354-8554 or email us at info@spinecenter.com any questions you might have concerning these procedures.

 

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