Lumbar degenerative disc disease (DDD) is a condition where a compromised disc leads to lower back pain. Unlike other parts of the body, spinal discs don’t have a blood supply so, when injured, either through trauma or general wear-and-tear, discs can’t repair themselves. Without this, an injury that would normally heal without any adverse effect on the body triggers degeneration in the disc. Despite the severity of its name, DDD is relatively common, impacting about 30% of people between the ages of 30 to 50 to some degree and becoming expected, rather than the exception, in patients over the age of 60.
What causes DDD?
Some people with DDD will experience only minor discomfort, but more potent lower back pain is usually a result of one, or multiple, factors.
- Inflammation results from proteins in the disk aggravating nearby nerves, both large and small
- Excessive micro-motion can combine with the inflammatory proteins
- Abnormal micro-motion instability is caused when the disc’s outer edges are worn down and fail to absorb stress on the spine
Treatment for DDD
In some cases, pain from DDD resolves itself over time — completely degenerated discs don’t contain any pain-causing inflammatory proteins. However, relief may take several decades to occur, and nonsurgical options can be effective treatment choices. Steroid medications to limit inflammation and pain, as well as physical therapy, can reduce the duration and intensity of discomfort.
Should pain persist beyond six months or impede a patient’s ability to conduct normal activity, patients should consider lumbar spinal fusion surgery. The surgery limits pain by halting any movement at the inflamed area. Depending on which area of the spine is impacted and how disabling the pain is, there are several different surgical procedures:
- A one-level fusion at the L5-S1 segment: this is the most common type of fusion as this area is most susceptible to DDD. These procedures don’t have a significant impact on the back as this segment has limited motion.
- A one-level fusion at the L4-L5 area. Given the range of motion, surgery on this section does hinder some of the spine’s normal movement
- A 2-level fusion is more complicated and problematic, although can be beneficial for patients with crippling pain. However, multi-level fusions greater than two are not recommended as the impact on the spine’s movement can be too detrimental
Spinal fusion surgery can help alleviate lower back pain and allow people to return to a healthy, active lifestyle. The development of less invasive options helps limit post-operative discomfort and risk, preserving more of the back’s normal structure and leading to more successful recoveries.
Dr. Leipzig is a Virginia spine surgeon with over two decades of experience and specializes in procedures including minimally invasive spine surgery and disc arthroplasty. Contact Virginia Spine Care today.