Spine Surgery

July 25, 2022

When Does Degenerative Disc Disease Need Surgery?


Degenerative disc disease occurs when the discs that cushion the spine begin to dry and wear out, causing pain and reducing mobility. There are some surgeries that can provide pain relief and help you return to normal function.

What is Degenerative Disc Disease?

Degenerative disc disease is a spine condition in which intervertebral discs—discs between the vertebrae—cause neck or back pain.

Intervertebral discs provide cushioning for your vertebrae, enabling your body to twist and bend. They also keep your back pliable and help it carry your body’s weight. These discs are primarily composed of water, and they dry out as we age. This causes them to lose their elasticity, flexibility, and ability to absorb shock. When the cushioning effect of the intervertebral discs wears off, the vertebrae start to rub against each other, causing pain. This condition is known as degenerative disc disease.

There are two types of degenerative disc disease:

  • Cervical degenerative disc disease affects the vertebrae in the neck. It leads to decreased range of motion, numbness, and neck stiffness.
  • Lumbar degenerative disc disease affects the vertebrae in the lower back. It causes discomfort and pain in the lower region of the body, especially when lifting, bending, or making other movements with your lower limbs.

Degenerative disc disease occurs more often in people who are over 40 years old. It is a progressive condition, so treatment involves managing pain and preventing further damage. Degenerative disc disease can be treated with non-invasive options as well as surgery.

What Happens When Degenerative Disc Disease Isn’t Treated?

When degenerative disc disease is left untreated, it may lead to the following:

What are Some Non-Invasive Treatments for Degenerative Disc Disease?

Non-invasive treatments for degenerative disc disease include:

  • Medications, including non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxers, or steroids to relieve pain and relax the tensed muscles in the region affected by the disease
  • Steroid injections near spinal discs, nerves, or joints to reduce pain and inflammation
  • Physical therapy, including stretching and strengthening exercises
  • Radiofrequency neurotomy, or the use of electric currents to burn sensory nerves around the affected area to prevent pain signals from reaching your brain

Your doctor may also recommend some home remedies to reduce inflammation and relieve pain and soreness. These could include:

  • Alternating the use of heating pads and ice packs every 10-15 minutes, three to four times a day, to help reduce soreness and inflammation
  • Regular exercise, such as walking or swimming, to help relieve pain and strengthen back muscles
  • Stretching, such as yoga, to help improve posture and relieve tension

When is it Time to Consider Surgery for Degenerative Disc Disease?

Surgery is usually not required for degenerative disc disease. However, there are situations that may cause you to consider surgery.

  • When non-surgical treatments have been utilized for about six months with no success, surgery should be considered.
  • When there are only one or two damaged discs, surgery can increase mobility for optimal functioning.
  • When you are young, you tend to respond better to surgery. Young patients typically recover faster and face fewer complications.
  • When cauda equina syndrome is discovered, surgery is needed. Though rare, this condition develops when the nerve roots bundle, causing compression in the lower spine. The syndrome usually results in paralysis, bowel or bladder control loss, and other significant complications.

What are the Surgical Options for Degenerative Disc Disease?

Degenerative disc disease surgery can be categorized into three primary types: spinal decompression, fusion, and artificial disc replacement.

Spinal Decompression Surgery

Spinal decompression surgery aims to relieve pressure on the nerve roots or spinal cord. There are a few different types of spinal decompression surgery:

  • Laminotomy creates a larger opening in the bony plate, or lamina, at the back of the vertebra.
  • Laminectomy removes the lamina to help relieve pressure.
  • Foraminotomy creates a larger opening in the foramen, which is where the spinal nerve exits the vertebra.
  • Facetectomy is the removal of a facet joint to reduce pressure on one or more spinal nerves.
  • Discectomy is the removal of all or part of a disc.
  • Corpectomy (also called vertebrectomy) removes the entire affected vertebra.

Fusion Surgery

Also referred to as stabilization, spinal fusion surgery aims to prevent motion between the vertebrae by fusing two or more vertebrae together. This procedure is used to treat spinal instability, deformities of the spine, or herniated discs.

In a fusion surgery, bones or bone-like materials are placed between the affected vertebrae to fuse them. Rods, metal plates, cages, or screws may be used to hold the vertebrae together. The vertebrae will then heal into a solid unit.

Artificial Disc Replacement

Also known as intervertebral disc arthroplasty, artificial disc replacement involves surgically removing the degenerated disc and replacing it with an artificial one.

Emergency Surgery

Emergency surgery for degenerative disc disease may occur when urgent medical attention is required. Symptoms like weakness in the legs, severe lower back pain, leg pain traveling down to the feet, or bowel or bladder incontinence may indicate the need for urgent medical care. These symptoms could also indicate cauda equina syndrome or another severe disorder.

What if My Doctor Recommends Surgery for My Degenerative Disc Disease?

When your degenerative disc disease needs surgery, you will need to consult a spine surgeon to decide which surgery fits your condition. Your medical history will be reviewed, and you will undergo some imaging tests to determine the location and severity of the affected discs.

Here are some questions to ask your spine surgeon:

  • Why is the surgical option recommended?
  • What possible alternatives are there?
  • What complications will arise if I don’t get the surgery?
  • What are the benefits and risks of the procedure?
  • How long is the recovery period?
  • Will there be post-surgical therapy?
  • Will there be pain after surgery? How will it be managed?
  • What is considered a successful procedure?
  • What are the long-term effects of the procedure?
  • How many of these procedures have you performed?
  • What is your success rate with this procedure?

How Long is the Recovery Period for Degenerative Disc Disease Surgery?

Patients who undergo surgery for degenerative disc disease tend to recover within one to four weeks, depending on their general health and the underlying cause of their disease. No heavy lifting or activity is allowed during your recovery period. Most people with sedentary jobs can get back to work within two to four weeks of the procedure. It could take up to 12 weeks for those with more strenuous jobs to safely return to work.

You will have pain and soreness at the incision site after the surgery, so it’s best to do little to nothing for a few days. Your surgeon may prescribe pain relief medication or advise you to use an ice pack on your incision site. He may also recommend physical therapy to help relieve pain. If your pain persists, see your doctor for further evaluation and treatment.

What Are the Risks Involved with Degenerative Disc Disease Surgery?

The risks of degenerative disc disease surgery include nerve damage, worsened pain, numbness, paralysis, lung collapse, and deep vein thrombosis. The risks for complications become more significant if two procedures are carried out in conjunction, such as discectomy and fusion. Your surgeon may prescribe drugs to combat these complications, and another surgery may be scheduled to treat nerve damage.

Is Degenerative Disc Disease Surgery Right for Me?

Degenerative disc disease may progress to the point where surgery is your best chance for increased mobility. If you have been receiving treatment with no success, surgery might be the next step. Consult the spine surgeons at Arkansas Surgical Hospital to decide if surgery is right for you.

The surgeons at Arkansas Surgical Hospital have performed hundreds of surgeries for degenerative disc disease to help patients seek pain relief and return to normal function. Our specialists will evaluate the severity of your degenerative disc disease to determine if you need surgery. Their evaluations will help them decide on the right approach for treating your spine. Request an appointment online or call (501) 748-8000 to schedule a consultation.

Photo by CHUTTERSNAP on Unsplash

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