Degenerative spondylosis is also called degenerative disc disease. An imaging study such as MRI, CT scan, myelogram or discogram can be used to diagnose this condition. As the disease progresses, disc herniation may result. This can cause extreme pain and other debilitating neurological symptoms. Surgery is usually recommended if non-surgical therapies fail to manage the symptoms.
Disease Pathology
Scientists are unable to determine the reasons for degenerative spondylosis. As degeneration proceeds, however, the disc's soft inner core becomes dehydrated. According to the website SpineUniverse, the outer fibrous wall then begins to break down. The result is a loss in the disc's mechanical strength and the disc space begins to collapse between the forces of opposing vertebrae. As more pressure is exerted, tiny rips begin to occur in the outer disc wall. With additional pressure from the vertebrae, the inner disc material can push out and cause a bulge in the disc wall. With time, the bulge can protrude through one of the small rips and herniate out of the disc. When the herniated portion presses against an adjacent spinal root or on any part of the spinal cord, then pain and other neurological symptoms begin to show.
Risk Factors
Degenerative spondylosis is age-related. According to MDGuidelines, the older the person the more the disc dehydrates. This begins a cascade of events leading to disc degeneration and herniation. People most at risk are those younger than 40 and those who pick up heavy objects on a routine basis. Also, a person is at risk if they participate in high-impact sporting activities or are exposed to repeated vibrations. Smoking cigarettes, former injuries to the spine, nutrition and the level of daily physical activity all play a role in a person's risk for degenerative spondylosis.
Typical Symptoms
The symptoms of degenerative spondylosis depend on which spinal level is involved and whether the spinal cord or spinal nerves are affected. In cervical vertebrae involvement, symptoms such as pain, numbness or weakness can be experienced from the neck to the hands or feet, according to the British Medical Journal, 2001. If the involved disc is in the lumbar area then pain and other neurological symptoms can appear in the lower back, hips, buttocks and legs. In either case, sensory dysfunctions called parasthesias can also occur. More severe conditions can result in muscle weakness, partial paralysis, and difficulty with walking.
Conservative Therapies
Initial treatment of degenerative spondylosis is usually approached conservatively. The Mayfield Clinic says this means such treatments may include physical therapy, massage therapy, rest, chiropractic techniques, an exercise regimen and pain management. Analgesics, muscle relaxers and non-steroidal anti-inflammatory drugs also can be used to help control symptoms. Cedars-Sinai suggests that intra-spinal steroid injections can also help, as can back braces, electrotherapy, activity modification and stress management.
Surgery
When conservative therapies fail or when symptoms worsen, surgery is generally advised. The goal of surgery is to remove the entire disc or the herniated portion causing the symptoms. According to MDGuidelines when the intervertebral disc is completely removed the spine often requires fusion. This means that two vertebrae are encouraged to grow together so they do not move. Fusion may necessitate metallic hardware such as screws and plates to hold the bones in place. With time, the vertebrae fuse into one solid bony unit which eliminates movement between them.
References
- SpineUniverse: How Degenerative Disc Disease Progresses
- MDGuidelines: Displacement, Cervical Intervertebral Disc Without Myelopathy
- "British Medical Journal"; Degenerative cervical disc disease causing cord compression; P. Bently, et. al.; February, 2001
- Mayfield Clinic: Degenerative disc disease
- Cedars-Sinai: Degenerative Disc Disease
