Degenerative Disc Disease in North Texas

Degenerative disc disease is one of the most common problems we help patients manage. It refers to symptoms that occur anywhere in the spine that is caused by wear and tear on a spinal disc. As we age, the discs in the neck and mid/lower back can deteriorate. This can be due to aging, overuse, trauma, or years of performing certain motions or movements. This deterioration, otherwise known as degeneration, can begin to cause a cascade of problems leading to neck and back pain and mobility issues. Dr. Kendall Carll is a board-certified spine surgeon who deploys innovative and proven techniques to treat degenerative disc disease. With a thorough examination, he will provide a conservative treatment plan that helps manage the condition to reduce flare-ups and diminish daily pain.

Your spine consists of a column of 33 stacked and interlocking bones called vertebrae. The top 24 of these bones are separated by a series of gel-like intervertebral discs. These spinal discs are like jelly donuts, with softer centers encased within tougher, banded exteriors. In the spinal section near the pelvic region, the last nine vertebrae are more or less fused together and don’t have discs, since they don’t require the ability to bend or twist. When we are born, each vertebral disc is composed of about 80% water, which gives them their spongy quality and allows them to function as shock absorbers for the spinal column. As we age, the disc fluid begins to dehydrate and degenerate, leading to loss of motion between vertebral disc. Further degeneration occurs once the mobility is limited or lost.

The pain from degenerative disc disease is typically caused when the outer section of the disc (called the annulus) bulges and pinches, or squeezes a nearby nerve or the spinal cord itself. If the disc completely ruptures, the leaking gel-like substances inside the center of the disc can stimulate an inflammatory immune response from the body, irritating the nerve branch or the spinal cord and causing pain. As discs leak, they also can physically compress like a balloon that is flattened, shrinking the space between each vertebra that allows the vertebrae or the spinal processes to rub against each other, causing sharp pain.  

The process of disc degeneration is a natural part of aging, not disease driven, despite the name “degenerative disc disease.” Most people over age 60 have some level of disc degeneration in the cervical region and other regions of the spine. The physical effects of this disc degeneration vary, causing minimal pain for some and significant pain for others. In either case, degenerated discs that have ruptured will not heal themselves, so treatment of some type is necessary.

The most common symptom of degenerative disc disease is a slow, dull ache. The defective disc can also generate painful flares when the back is under stress. Degenerative discs can cause muscle spasms or radiate pain in either the arms or legs, depending on the location of the disc. The pain can dissipate with certain movements or body positions, such as reclining or lying down.

To understand the degree of degenerative disc disease, most physicians will request MRI or a CT scan. These scans can provide an image that helps pinpoint which disc might be responsible for the pain. However, some studies have shown that even young adults can have some level of disc degeneration and not experience any pain. One other diagnostic measure is the discogram. During a discogram, a physician uses a special needle to inject dye directly into the soft center of one or more discs. The dye allows the doctor to see any abnormality in a disc's exterior, which can then be seen on an x-ray or CT scan. Some doctors use a discogram before spinal fusion surgery to help identify which discs need to be removed, but many doctors rely mainly on MRI and CT scans to diagnose disc problems and guide treatment.

The primary focus in treating degenerative disc disease is pain management. After your consultation with Dr. Carll, a combination of approaches can be taken to help minimize pain and offer relief. It is rare that a single treatment approach is used, and there is no set formula that works for everyone. Some nonsurgical treatments include:

• Over-the-counter pain medications
• Prescription pain medications
• Epidural steroid injections (ESIs) into the space surrounding the disc
• Physical therapy

Most patients are able to find relief from pain using a combination of the above nonsurgical approaches, but for some patients, surgery is the best option. Rarely is open spine surgery required to address degenerative disc disease. The most common option is a type of minimally invasive surgery, which can be performed on an outpatient basis. This allows patients to benefit from a shorter recovery and subjects the body to less trauma. The specific surgical approach for degenerative disc disease will depend on the severity of deterioration and the location of the disc(s). Some of the surgical approaches involve partially or completely removing the affected disc and stabilizing the affected area of the spine by fusing the vertebrae together. In some cases, especially when the defective disc is in the neck, surgeons can insert artificial discs to preserve flexibility. The best approach for addressing degenerative disc disease will be decided based on your lifestyle goals.   

Dr. Carll specializes in helping patients with degenerative disc issues find solutions that work. Starting with a carefully planned, nonsurgical approach he will help find ways to get you back to your active life with less pain. As an experienced board-certified spine surgeon, Dr. Carll uses the latest advancements in minimally invasive surgery. We invite you to call our spine center and schedule your appointment today.