The Purpose of Degenerative Disc Disease Surgery

For most patients with degenerative disc disease, surgery won't be necessary. Doctors typically recommend that patients with the condition first exhaust all forms of nonsurgical, conservative treatments, such as physical therapy, pain medication, behavior modification, and low-impact exercise, among others. Surgical procedures are usually reserved for patients with chronic, debilitating symptoms who have not responded to several weeks or months of conservative treatments. To understand how a surgical procedure could help a patient with degenerative disc disease, it can be helpful to first learn about how the condition evolves and the symptoms it can produce.

What is Degenerative Disc Disease?

Degenerative disc disease (DDD) is a spinal condition that involves the deterioration of the intervertebral discs. While most people will exhibit some form of age-related spinal degeneration by their 50s or 60s, DDD can afflict individuals in their 20s or 30s. In other words, in people with DDD, the intervertebral discs degenerate at an earlier age and at a faster rate.

Degenerative disc disease has many causes, including obesity, excessive physical activity, an overly sedentary lifestyle, and genetic predisposition. These can all add additional stress to the spine and contribute to accelerated disc degeneration, which compromises the overall stability of the spine. As a disc breaks down and becomes weaker, it has a harder time properly supporting the vertebrae above and below it. Microscopic movements can occur in an affected vertebral segment and may cause disc pain, as inflammation-inducing proteins irritate the nerve fibers embedded in a disc's outer wall. Over time, disc deterioration could also lead to bulging or herniated discs, spinal osteoarthritis, or vertebral slippage. Anatomical abnormalities such as these may come in contact with the spinal cord or nerve roots and cause symptoms of focal pain and radiating pain, numbness, weakness, and tingling in the extremities.

Surgery May Help Relieve Symptoms

In the event that degenerative disc disease surgery is necessary to treat symptoms, the procedure will likely focus on relieving pressure from compressed neural structures. A laminotomy, for example, is a procedure that partially removes bone from the lamina (a bony plate in a vertebra that protects the spinal cord). Removing some of this bone can allow more room for a bulging or herniated disc to expand, preferably away from the neural structure it is compressing. In some cases, the entire degenerative disc may need to be removed during a procedure known as spinal fusion, which utilizes bone grafts, support cages, and other hardware to halt movement in a vertebral segment. It's important for patients to research and understand each surgical procedure available to them, obtain additional medical opinions, and confirm that all conservative treatments have first been exhausted.