Aging Disk Treatments

The spine is a chain of vertebrae (plural form of vertebra) that supports the trunk to maintain upright posture. The discs are cushion-like structures between each two vertebrae holding them together and protecting them from hitting into each other in loading conditions such as sitting, standing, walking, running or lifting. In addition, each disc serves as a motion point so the vertebrae can lean slightly forward, backward or to the side over each other to bend the trunk forward, backward or to the sides. Therefore, the discs are under significant load constantly making them one of the very first body organs to start to age, usually around the age of 30. The speed of this aging process and whether it becomes symptomatic or not varies among individuals depending on genetic factors and life habits such as job, hobbies and other daily activities. When the discs age, they either collapse (converting into flat cushions), or bulge toward outside losing their nice round shape. In addition, other injuries such as disc herniation (as if the case of the cushion breaks and the material inside comes out) may happen and speed up the aging process of the discs.

The availability of technologies such as magnetic resonance imaging (MRI) has led to typical scenario of patients in spine clinics being concerned about MRI findings of multiple aged discs with collapse, bulging or even herniations. What is usually missed is the fact that aging of the discs (medically speaking degenerative disc disease) is common and in fact expected. If degenerative disc disease becomes symptomatic, the first line of treatment consists of lifestyle change and avoidance of harmful activities as much as possible. Other supportive treatments include pain medications, muscle relaxers, icing/heating (depending on preference) or gentle massage. Fortunately, the majority of patients are able to handle their symptoms with these strategies and can function well or reasonably well without further treatment. Surgery is not indicated and cannot provide further relief for most patients with aged discs.

However, surgery can be substantially helpful if the degenerative disc disease is associated with other abnormalities such as narrowing of the vertebral canal (medical term: spinal stenosis), slipped vertebrae (medical term: spondylolisthesis), pinched nerves or spinal cord (medical term: nerve/cord compression), spinal deformities (medical terms: scoliosis or kyphosis) and many other conditions. In fact, the surgery works best in patients who have severe symptoms (such as radiating pain, tingling/numbness or weakness in arms or legs), concerning findings in the physical exam and perhaps most importantly in whom the spine condition is a major limiting factor to their desired level of physical activities. Again, surgery would be indicated only in patients who failed to improve after trying all potential nonsurgical treatments. Various surgical options are available for these conditions and at the Orthopedic Spine Center of Methodist Hospital, we trim these surgical options based on the condition of the spine, patients’ baseline health and their specific needs. We feel privileged to be able to offer all cutting edge surgical techniques and technologies to provide our patients with maximum quality of care.

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