What is Degenerative Spine Disease?
Degenerative spine disease refers to the natural aging process of the spine, where the structures of the spine gradually wear down over time.
This is a very common condition and can affect people differently. Importantly, no two spines are the same, and the degree of degeneration does not always correlate with symptoms.
What Parts of the Spine Are Affected?
Degeneration can involve multiple components of the spine, including:
- Intervertebral discs: Loss of hydration and height, which can lead to disc bulging or collapse
- Facet joints: Arthritic changes that can cause pain and stiffness
- Ligaments: Thickening (such as ligamentum flavum hypertrophy) that can contribute to spinal narrowing
- Spinal alignment: Changes in posture or curvature over time
These changes can lead to conditions such as spinal stenosis, nerve compression, or instability.
Why is This Condition Highly Individualized?
Degenerative changes vary significantly from person to person. Factors include:
- Anatomy and alignment
- Activity level
- Genetics
- Location and severity of degeneration
As a result, treatment must be tailored to both imaging findings and clinical symptoms, rather than imaging alone.
Symptoms
Symptoms depend on the structures involved and may include:
- Neck or back pain
- Radiating arm or leg pain
- Numbness or tingling
- Weakness
- Difficulty walking or maintaining balance
Treatment Options
Conservative Management
Many patients improve without surgery. Initial treatment often includes:
- Physical therapy
- Activity modification
- Medications
- Spinal injections
Surgical Treatment
When symptoms are severe, progressive, or do not respond to conservative care, surgery may be considered.
Surgical treatment generally falls into two broad categories:
- Decompression:
Relieving pressure on nerves by removing structures that are causing compression - Decompression with Fusion:
In addition to decompression, stabilizing the spine by fusing vertebrae together
The decision between these approaches depends on several factors, including:
- Presence of spinal instability
- Spondylolisthesis (slippage of one vertebra over another)
- Degree of degeneration
- Overall spinal alignment
- Patient symptoms and functional status
Our Approach
We take a comprehensive and individualized approach to degenerative spine disease.
Treatment decisions are based on a combination of:
- Detailed imaging findings
- Clinical symptoms
- Patient goals and lifestyle
Whenever possible, we begin with conservative management. When surgery is indicated, we carefully select the least invasive and most effective approach, whether that involves decompression alone or stabilization with fusion.
View the approach