Degenerative Spine Disease
What Is It?
Degenerative spine disease is a general term that refers to any disease of the spinal column that results from the aging process and wear and tear that occurs to the bone and soft tissues of the spine. While some of this type of spinal disease is normal with the normal aging process, some people appear to be more prone to the development of this type of spine disease than others. Additionally, people who put increased strain on their necks and backs can increase the rate at which this wear and tear occurs.
The term degenerative spine disease does not refer to any one pathology of the spine, it is a general term that encompasses many types of disorders, many of which can occur simultaneously in the same patient. Some of these specific types of degenerative spine disease are listed here and more details about each can be found on their own respective pages.
Some Types of Degenerative Spine Disease
- Herniated Discs: A herniated disc is a protrusion of an intervertebral disc, the "cushion" that sits between each vetebral bone of the spine. It can happen suddenly with a trauma, but more commonly occurs over years. It can cause pain and also compress nerves in the area, leading to sensory or motor symptoms in the arm or leg, depending on the location of the herniation. The most common sites are lumbar herniated discs (low back) and cervical herniated discs (neck). Thoracic herniated discs (mid-back) are much less common.
- Spinal Stenosis: Stenosis is a term that describes narrowing of a structure. In this case, it is narrowing of the spinal canal, in which the spinal cord sits. Over time, as this narrows from build up of tissue around the spine, it can start to cause symptoms by compressing the nerves and spinal cord. Stenosis occurs most commonly as lumbar stenosis and cervical stenosis. In addition, stenosis is sometimes used to refer to Foraminal Stenosis, which is narrowing of one or more foramen, the holes that the spinal nerves go through to exit from the spinal column.
- Spinal Instability: Normally, the spine and all its ligaments and muscular support are stable. It moves only in certain ways and other types of movement is limited. Smooth bending and turning of the column keeps the spinal cord and spinal nerves happy and safe. However, with severe degenerative spine disease, this normal stability can become lax and lead to abnormal weakness in certain areas. This is spinal instability. Instability can both lead to pain as well as injury to the spinal cord or spinal nerves, both of which can cause neurological symptoms. Instability can also occur acutely as the result of a trauma which tears supportive soft tissues or breaks bones of the spine.
What Types of Symptoms Are Typical?
The symptoms that are caused by degenerative disease of the spine vary tremendously depending on the specific pathology a patient has. Pain, both in the back or neck and in the arms or legs, is a common finding. Additionally, neurological symptoms due to compression of spinal nerves or even the spinal cord itself can occur as well in some cases. This can typically cause sensory symptoms (such as numbness, tingling, pain, etc.) as well as motor symptoms (weakness or paralysis, muscle wasting, abnormal reflexes, etc.). Again, each patient and each pathology is different. You can learn more for each of the types of degenerative disease listed above.
In general, lumbar (low back) disease will lead to low back and leg symptoms while cervical (neck) disease can lead to neck and arm symptoms.
How Is The Diagnosis Typically Made?
Again, diagnosis varies depending on the specific pathology in each patient. However, many of these disorders are at least partially recognized by the history of symptoms as well as a thorough neurological examination. If these suggest spine disease, imaging studies of the spine are often ordered. While many patients first get plain x-rays of the spine, CT scans
and MRI scans
are the best for really elucidating the pathology of the spine.
In particular, CT scan is good for defining bony anatomy and any fractures or dislocations of bone structures in the spine. It is not as good for demonstrating soft-tissue abnormalities.
The MRI gives the best resolution of soft tissues so that fine detail can be seen. It can easily demonstrate herniated discs, stenosis, nerve compression and other more subtle findings.
Rarely, a myelogram is used as well. This study uses the injection of a contrast dye into the cerebrospinal fluid in the spine to help elucidate some pathologies of the spine on x-ray or CT scan.
What Are Some Common Treatments?
Treatment for degenerative spine disease varies considerably depending on the specifics of each case. Some patients benefit from conservative therapy with rest and physical therapy. Others benefit from injections of the spine. Some cases require surgical intervention. You can learn more about these for each of the specific types of disease on their respective pages. However, no generalizations can be made as each patient and each disease is unique. Each patient should discuss their most appropriate treatment plan with their personal physicians.
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This site is not intended to offer medical advice. Every patient is different, and only your personal physician can help to counsel you about what is best for your situation. What we offer is general reference information about various disorders and treatments for your education.