Brain and Spine Surgery



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Overview

 


Degeneration of the intervertebral disc, often called "degenerative disc disease" (DDD) of the spine, is a condition that can be painful and can greatly affect the quality of one's life. While disc degeneration is a normal part of aging and for most people is not a problem, for certain individuals a degenerated disc can cause severe constant chronic pain


Causes


There are several possible causes for Degenerative disc disease. Sometimes discs becomes dry and shrunken due to leaking of protein from the disc. Degenerative disc disease can result from trauma (acute or chronic / repetitive), infection, or the natural processes of aging. It can euphemistically be referred to as the “grey hairs of the spine”.


Risk


The following factors may increase your risk of degenerative disc disease :

  1. Age : - 30s or 40s
  2. Family history of degenerative disk disease
  3. Athletes
  4. Any kind of Back injury


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Symptoms


  1. Local Pain
  2. Stiffness
  3. Muscle tingling, numbness, or weakness
  4. Restricted activity / Loss of mobility
  5. Symptom relief with certain movements or positions
  6. Radiating upper body symptoms with cervical DDD.
  7. Pain in the low back, buttocks, thighs, or neck
  8. Pain that worsens when sitting, bending, lifting, or twisting
  9. Pain that feels better when walking, changing positions, or lying down
  10. Periods of severe pain that gets better after a few days or months
  11. Numbness and tingling into the legs
  12. Weakness in the legs
  13. Foot drop (inability to raise the foot at the ankle)



Diagnosis


Degenerative disc disease is diagnosed with a medical history and physical examination. During the exam, your doctor should check for range of motion and pain associated with the affected area, as well as any tenderness, numbness, tingling, or weakness.

Blood and / or urine tests to rule out other causes of pain
MRI Scan —a test that uses magnetic waves to make pictures of structures inside the body
X-ray —a test that uses radiation to take a picture of structures inside the body, especially the bones
Discography —injecting dye into the affected spinal area of an awake patient to obtain clearer x-ray images


Treatment


For acute or sudden neck pain, doctors prescribe pain relief medications such as acetaminophen, anti-inflammatory agents, and muscle relaxants. Temporary bed rest or a brace may also be suggested. Usually patients are encouraged to get up and gradually increase their activities of daily living.

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Physical therapy is often prescribed, and usually includes stretching exercises to improve flexibility and extension exercises to help maintain the spine’s natural curve. A hot/cold therapy and gentle massage can also be beneficial for neck pain. After acute symptoms subside (usually within two to three weeks), patients are encouraged to begin a daily exercise regimen. This may include low impact aerobics three times per week as well as daily neck exercises.

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Surgical Treatment of Degenerative Discs Disease


Patients who suffer from a herniated disc, ruptured disc, or degenerative disc disease, and have failed conservative therapy are often treated with an Anterior Cervical Discectomy and Fusion. An Anterior Cervical Disectomy and Fusion has been the gold standard of treatment.


Anterior Cervical Discectomy

This procedure reaches the cervical spine (neck) through a small incision in the front of the neck. The intervertebral disc is removed and replaced with a small plug of bone or other graft substitute, and in time, will fuse the vertebrae. While Anterior Cervical Discectomy and Fusion remains the gold standard for treatment of cervical disc herniations and degenerative conditions of the cervical spine, the use of motion sparing techniques such as artificial disc placement are under investigation world wide.


Cervical Corpectomy

This procedure removes a portion of the vertebra and adjacent intervertebral discs, which allows for decompression of the cervical spinal cord and spinal nerves. A bone graft, and, in some cases, a metal plate and screws, stabilizes the spine.







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