Template:Condition

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This is a picture of the spinal nerves exiting the verterbal column. The nerves are color coded by section
This is a close up picture of the cauda equina.
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Clinically Relevant Anatomy
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Dengenerative Disc Disease (DDD) is thought to begin with changes to the annulus fibrosis, intervertebral disc, and subchondral bone. The process of degeneration is divided into three classifications including: early dysfunction, intermediate instability, and final stabilization.[1]

Mechanism of Injury / Pathological Process
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Degenerative disc disease refers to a condition in which the involved disc causes LBP. Lumbar degenerative disc disease is usually the result of a twisting injury to the lower back, such as when a person swings a golf club or rotates to put an object on a surface to the side of or behind them. [2]

The pain is also frequently caused by simple wear and tear on the spine and comes with the general aging process.

Degenerative disc disease is fairly common, and it is estimated that at least 30% of people aged 30-50 years old will have some degree of disc space degeneration, although not all will have pain or ever receive a formal diagnosis. [3]


Clinical Presentation[edit source]

People with DDD will have low back pain; however there are varying levels of severity. Pain is often chronic, but one with DDD can experience varying episodes of exacerbation where pain levels are elevated [4]  

DDD commonly occurs with other diagnoses such as:

  1. idiopathic low-back pain
  2. lumbar radiculopathy
  3. myelopathy
  4. lumbar stenosis
  5. spondylosis
  6. osteoarthritis
  7. zygapophydeal joint degeneration

Activities that typically increase pain include: 

  • Sitting for extended periods of time
  • Rotating, bending, or lifting

Activities that typically decrease pain include:

  • Changing positions often
  • Lying down
  • Staying active;[5]  

Diagnostic Procedures[edit source]

Patients may present with a history of Chronic LBP, and can experience symptoms into the buttock. They may also state a history of spine stiffness that gets worse with activity and tenderness with palpation over involved area. [6]

Xray findings are used to diagnose DDD. Anterior-Posterior and lateral views are taken; presence of osteophytes, narrowing of the disc joint space, or a “vacuum sign” is noted. [7]

Outcome Measures[edit source]

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Management / Interventions
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Differential Diagnosis
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Key Evidence[edit source]

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Resources
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Case Studies[edit source]

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Recent Related Research (from Pubmed)[edit source]

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References[edit source]

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  1. ↑ Dutton M. Orthopaedic Examination, Evaluation, and Intervention. 2nd ed. New York, NY: McGraw-Hll; 2008.
  2. ↑ Ullrich, P. F. (2006 11 6). Lumbar Degenerative Disc Disease. Retrieved 06 02, 2009, from Degenerative Disc Disease: http://www.spine-health.com/conditions/degenerative-disc-disease/lumbar-degenerative-disc-disease
  3. ↑ Ullrich, P. F. (2006 11 6). Lumbar Degenerative Disc Disease. Retrieved 06 02, 2009, from Degenerative Disc Disease: http://www.spine-health.com/conditions/degenerative-disc-disease/lumbar-degenerative-disc-disease
  4. ↑ Ulrich, P. F. (2005, 11 29). Common Symptoms of Degenerative Disc Disease. Retrieved 06 02, 2009, from Degenerative Disc Disease: http://www.spine-health.com/conditions/degenerative-disc-disease/common-symptoms-degenerative-disc-disease
  5. ↑ Ulrich, P. F. (2005, 11 29). Common Symptoms of Degenerative Disc Disease. Retrieved 06 02, 2009, from Degenerative Disc Disease: http://www.spine-health.com/conditions/degenerative-disc-disease/common-symptoms-degenerative-disc-disease
  6. ↑ Thompson, J.C. MD. Netter's Concise Atlas of Orthopaedic Anatomy. (2002) Saunders Elsevier. p.36-7
  7. ↑ Thompson, J.C. MD. Netter's Concise Atlas of Orthopaedic Anatomy. (2002) Saunders Elsevier. p.36-7
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