Degenerative Disc Disease Surgery

Degenerative disc disease, or DDD, is a condition involving damaged intervertebral discs. It develops gradually, often due to age-related spinal changes, but can also be triggered by overusing the spine. 

In some cases, degenerative disc disease surgery may be necessary to resolve chronic back pain and disability. Read on to learn more about this prevalent spinal condition and when to consider surgery for your symptoms. 

Table of Contents

Stages of Degenerative Disc Disease

The stages of degenerative disc disease include dysfunction, dehydration, stabilization, and collapsing. 

Stage 1: The Dysfunction Stage

The dysfunction stage occurs when the affected discs begin to lose normal function. This leaves the spine vulnerable to shock and high-impact movements. Additionally, as the discs lose function, they become less able to support the spine’s natural structure, often leading to misalignment. 

For many people, the dysfunction stage is symptom-free. Others experience mild back pain and discomfort. 

Stage 2: The Dehydration Stage

Healthy spinal discs are well-hydrated and able to absorb impact. As they degenerate, the discs become weaker, drier, and more susceptible to herniation or rupture. During this stage, back pain typically worsens. 

Stage 3: The Stabilization Stage

In this stage of degenerative disc disease, the spine tries to stabilize itself after losing strength. For many people, this involves bone spur development.  

Bone spurs (also known as osteophytes) are pieces of excess bone that can form on the vertebrae. They develop as your body attempts to counteract the increased impact on the spine. Bone spur growth may decrease the spine’s mobility, leading to stiffness and tightness.

For some people, the stabilization stage causes spinal stenosis. Spinal stenosis is the narrowing of the spinal canal, which can occur as your body tries to improve stability. The narrowing canal may press on spinal nerves, potentially triggering symptoms like radiating pain, weakness, tingling, and numbness. 

Stage 4: The Collapsing Stage

This is the last stage of degenerative disc disease. At this point, the spinal discs are very weak, thin, and dehydrated, providing no protection for the spine. Some people in this phase may have severe bone spurs and spinal deformities. 

In the collapsing stage, you may experience severe, debilitating back pain and neurological symptoms. Generally, stage 4 degenerative disc disease is irreversible but treatable with various therapies, including surgery.  

What Are The Symptoms of Stage 4 Degenerative Disc Disease?

Possible symptoms of stage 4 degenerative disc disease include:

  • Chronic back pain and radiating pain (lasting for longer than three months)
  • Numbness, weakness, and/or tingling that radiates from the lumbar spine into the lower extremities
  • Severely limited spinal mobility
  • Disrupted daily activities

Can Degenerative Disc Disease Lead to Paralysis?

Yes, degenerative disc disease can lead to paralysis, but rarely. Paralysis generally only occurs in severe, untreated cases of DDD.

Cases of degenerative disc disease that can lead to paralysis generally involve cauda equina syndrome. This complication of DDD occurs when the cauda equina (a sac of nerve endings at the bottom of the spinal cord) is compressed. Cauda equina syndrome requires immediate medical treatment to prevent paralysis. 

Warning signs of cauda equina syndrome include:

  • Lost bladder or bowel function
  • Reduced or lost sensation in the inner thighs, buttocks, backs of legs, feet, or heels
  • Weakness, numbness, or pain in one or both legs
  • Sudden onset sexual dysfunction
  • Paralysis or irregular reflexes in the legs or feet
  • Tingling, burning, or “pins and needles” sensation in the lower extremities

Receiving treatment for prompt degenerative disc disease prevents cauda equina syndrome and permanent nerve damage. 

What Is the Best Cure for Degenerative Disc Disease?

The best cure for degenerative disc disease depends on the individual but generally involves physical therapy or surgery. 

Cases of degenerative disc disease that can be cured without surgery are typically treated with physical therapy, lifestyle adjustments, and medication. Physical therapy is often highly effective for disc degeneration because it naturally alleviates pressure on the damaged disc through strengthening exercises, posture adjustments, and manual therapy. 

While conservative treatments like physical therapy may “cure” degenerative disc disease by resolving your symptoms, they can’t fully repair the damaged discs. This may only be done through surgery, like discectomy. Discectomy involves surgically removing some or all of a damaged intervertebral disc. 

In removing the disc(s) affected by DDD, your surgery can alleviate pressure on the spinal nerves. After removing some or all of the disc, the surgeon generally places an implant in its place to restore function and stability.  

Can a Degenerative Disc Be Fixed Without Surgery?

A degenerative disc can be fixed without surgery if it’s treated early and the patient adheres to their prescribed treatment plan. 

Treatments used to treat degenerative disc disease without surgery include:

  • Physical therapy: Your physical therapist will likely focus on spinal stabilization exercises for degenerative disc disease. These exercises strengthen the muscles that stabilize the spine, helping to reduce impact on damaged discs. 
  • Medications: Anti-inflammatory medications can reduce pain and pressure on the spinal nerves. Most people start with over-the-counter medications for degenerative disc disease, progressing to prescription medications only if necessary. 
  • Epidural steroid injections: This treatment involves injecting steroid medication into the epidural space. It can alleviate symptoms of a spinal pinched nerve caused by a degenerative disc. 
  • Massage therapy: Massage can boost blood flow to degenerative discs, helping to promote tissue regeneration. Given that poor circulation can weaken the spinal discs, massage can play a valuable role in your healing process. 
  • Lifestyle changes: Your physician will suggest lifestyle changes to promote spinal disc health. These changes may include avoiding high-impact exercise, remaining mobile with low-impact exercise, eating a nutritious diet, and improving your posture. 

Sometimes, even with early intervention and conservative treatments, a degenerative disc continues to trigger pain. In these cases, patients may need to consider surgery to successfully manage their symptoms. 

What Surgery Is Best for Degenerative Disc Disease?

The best surgery for degenerative disc disease is discectomy. 

As discussed in an earlier section, discectomy involves removing the damaged portion of the disc. This takes pressure off of the spinal nerves, relieving pain, weakness, tingling, and numbness. 

To replace the damaged disc tissue, surgeons use fusion or non-fusion spinal implants. Fusion implants contain bone graft material, which permanently fuses the vertebrae to re-stabilize the spine. 

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Non-fusion implants re-stabilize the spine without permanently fusing the vertebrae. Instead, they use flexible materials that move with the spine while providing stability. The TOPS System is one example of a dynamic non-fusion implant that creates a controlled range of motion in the spine after spinal decompression surgery. 

What Is the Future Treatment for Degenerative Disc Disease?

The future treatment for degenerative disc disease is stem cell therapy. Stem cells, among other regenerative materials, have the potential to regenerate damaged disc tissue without surgery. 

Regenerative therapies may help treat degenerative disc disease by stimulating the body’s tissue repair process. Stem cells can regenerate into virtually any specialized cell, making them a powerful solution for degenerative conditions. 

Stem cell therapy isn’t yet FDA-approved for degenerative disc disease. Further research is required to support this treatment option. For now, minimally invasive spinal decompression surgery with non-fusion implants is the most advanced treatment option available to patients with DDD.