Degenerative Disc Disease Lumbar Spine Treatment
Spinal discs provide cushioning, shock absorption, range of motion, and flexibility. They also play a major role in maintaining spinal alignment. Degenerative disc disease describes a gradual failure of the disc to perform its function causing reduced range of motion and back pain, in some cases. Degeneration and collapse of the vertebral disc may cause stress across the vertebrae, impingement of nerves, and the loss of alignment strains the paraspinal muscles. A degenerated disc cannot heal itself.
Lumbar degenerative disc disease is a common cause of sciatica, leg and back pain, weakness and numbness with walking and standing. When the damage progresses, it can impact the activities of daily life. The goal of treatment is reducing pain and improving function.
Treatment involves a combination of nonsurgical approaches including pain management with over-the-counter and prescription pain medications, as well as, therapeutic injections. Other options include activity and lifestyle modifications, rest, ice/heat therapy, and physical therapy. Chiropractic and massage therapy may be explored for temporary pain relief. Treatment is personalized for each patient. Most patients find relief with nonsurgical approaches without surgery.
Surgery is usually only recommended when the pain and disability are progressive, severe and persistent and when three months of nonsurgical management fails to improve pain and function.
Surgical treatment options depend on each patient’s specific diagnosis and surgical goals. Your Dallas Neurosurgical and Spine expert will conduct presurgical planning to determine the best approach for you, which may include non-surgical management versus lumbar discectomy with spinal fusion. There are two predominant surgical options:
Lumbar discectomy with spinal fusion
Fusion is the gold standard treatment for management of lumbar degenerative disc disease. It involves removing the entire worn disc, filling the void with a bone graft, and stabilizing the graft with implants, pins, rods, and screws to hold the spine in place while the graft heals. Fusion aims to relieve pain by fusing vertebrae together to eliminate painful movement in the joint.
Lumbar disc replacement
An alternative option is to replace the damaged disc with an artificial disc. Artificial disc replacement is generally only recommended when pain is related to one or two damaged discs in the lower spine, and there is no other significant joint disease or prior history of spinal surgery.
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