Degenerative Joint Disorders That May Require a Surgery

Mar 10, 2022

Degenerative joint disease is also referred to as osteoarthritis or OA. Osteoarthritis is the most widespread form of arthritis, and it’s mainly caused by age-related joint degeneration. 

Many different disorders fall under the umbrella of degenerative joint disease. If these disorders don’t respond to conservative treatments, surgery may be required for symptom relief. 

Let’s discuss the degenerative joint disorders that may require surgery, as well as available treatment options. 

Which Degenerative Joint Disorders May Require Surgery?

Degenerative joint disorders can gradually progress, become severe, and fail to respond to non-surgical treatment options.

Examples of degenerative joint disorders with the potential to require surgery include: 

Osteoarthritis

Osteoarthritis can severely diminish various joints in the body, including the knees, hips, and fingers, as well as the facet joints in the spine. If the condition becomes severe, it can cause chronic, debilitating pain and a loss of function of the affected joint. 

If non-surgical treatment options don’t resolve joint pain from osteoarthritis, the joint may need to be surgically removed and replaced with an artificial joint. 

Spondylosis

Spondylosis is a term that refers to spinal degeneration. It occurs when the spinal bones, called vertebrae, wear down and change with age. Oftentimes, spondylosis is called osteoarthritis of the spine or degenerative disc disease. 

Oftentimes, spondylosis can be effectively treated without surgery. Physical therapy, pain medications, chiropractic care, rest, and spinal injections have a high rate of success in spondylosis patients. 

However, if this degenerative condition doesn’t respond to non-surgical treatments and causes severe symptoms such as spinal instability and weakness, tingling, or numbness in the extremities, surgery may be required. 

Surgery For Spondylosis

Examples of surgical procedures that may be done for spondylosis include:

• Laminectomy, which involves removing some of all of the lamina, the bony layer of the vertebra that encloses the spinal canal
• Facetectomy, which involves removing one of the spine’s facet joints. Facet joints connect the vertebrae to allow for spinal motion and stability. 
• Laminotomy, which involves creating a larger opening in the spinal canal by removing some of the lamina
• Foraminotomy, which also involves creating a larger opening in the spinal canal, but by enlarging the space around the intervertebral foramen

These procedures are all forms of spinal decompression surgery, which we’ll discuss in greater detail below. 

Spinal Stenosis

Spinal stenosis is a condition that occurs when the space inside of the spinal canal narrows. It most often occurs as a result of spinal degeneration from the aging process. 

As the spinal canal becomes narrower with spinal stenosis, it can irritate and compress the spinal nerves. This may lead to back pain, along with numbness, tingling, and weakness in the extremities.  

Spondylolisthesis

Spondylolisthesis is a condition that occurs as a result of spinal instability. With this condition, one of the vertebrae slips out of place and settles on the vertebra beneath it. Spinal disc degeneration is a common cause of spondylolisthesis in older adults. 

When one of the vertebrae are out of alignment with spondylolisthesis, it can lead to back pain, stiffness, trouble walking and/or standing, and muscle spasms, along with numbness, tingling, and weakness in the foot. 

Spine Surgery For Degenerative Joint Disorders

Spine surgery for degenerative joint disorders may involve the following procedures:

Facet Joint Replacement

Facet joint replacement is a type of spine surgery that involves replacing a degenerated facet joint with a spinal implant, like the Premia Spine TOPS System. In this procedure, the surgeon will remove the affected facet joint and secure the implant in its place to stabilize the spine while relieving pain from spinal degeneration.  

Spinal Decompression

Spine surgery for spinal degeneration usually involves spinal decompression and fusion. Decompression surgery involves removing the spinal tissue that’s causing the patient’s symptoms, typically because it’s pressing on nearby spinal nerves.  

What’s Involved in Spinal Decompression?

During spinal decompression, the patient is first put under general anesthesia. Next, the surgeon creates an incision (often in the abdomen). The organs and other tissues then must be moved aside to create access to the spine. 

Once the surgeon has achieved access to the spine, he or she will remove the spinal tissues that are causing nerve compression. The type and amount of tissue that’s removed during spinal decompression can vary from patient to patient. 

With the spinal tissue removed, the surgeon typically then performs spinal fusion (or, as an alternative, places a spinal implant) to stabilize the spine. 

Spinal Fusion

After decompression is complete, spinal fusion is often performed to stabilize the spine. This procedure involves positioning bone graft material in between the affected vertebrae. The bone graft stimulates the fusion of the vertebrae in the months after the procedure. 

Downsides of Spinal Fusion

• Reduced spinal mobility

Spinal fusion prevents spinal instability. However, it also inhibits the motion of the spine. Patients largely lose the ability to twist, bend, and flex the spine after spinal fusion. 

Reduced spinal mobility can limit the patient’s activities and everyday movements after the spinal fusion. For example, some patients may no longer be able to bend over after fusion and may require tools to pick up items off of the ground. 

• Prolonged recovery process

Since fusion involves operating directly on spinal bone tissue, it also prolongs the recovery process for degenerative joint disease surgery. Patients require more downtime after spinal fusion, and the recovery process tends to be more painful than non-fusion procedures. 

• Risk of adjacent segment degeneration

Adjacent segment degeneration (ASD) can occur in patients who undergo spinal fusion. It’s a condition that occurs when the spinal bones around the fused vertebrae are placed under added stress. As a result, these portions of the spine degenerate more rapidly. 

Fusion Alternatives For Degenerative Joint Disease Treatment

Spinal implants like the TOPS System are alternatives to spinal fusion in surgery for degenerative joint disorders. In facet joint replacement and spinal decompression, an implant can stabilize the spine without compromising the patient’s mobility. 

The TOPS spinal implant moves with the spine, allowing the patient to twist and bend quickly after the procedure. As a result, patients experience relief from symptoms of spinal degeneration without compromising the normal motion of the spine. 

For more information about the TOPS System in degenerative joint disease treatment, contact Premia Spine today.