Intervertebral disc degeneration

Introduction Disc degeneration of the intervertebral disc is as inevitable as death, and occurs to everyone in varying degrees. But not everyone who has a degenerative lumbar vertebra will feel pain. Many people who appear to have normal waist have MRI findings of disc herniation, degenerative changes, and spinal stenosis. It is important to recognize that the condition of each patient is different and that not every person with degenerative disc changes has symptoms. Degenerative discs can lead to several different symptoms, including lumbar pain, leg pain, and weakness caused by nerve root compression. The cause of these symptoms is intervertebral disc wear, because the disc loses its original function and causes pain once it is worn, and if the disc shrinks, the space for the nerve root becomes smaller. Intervertebral disc wear between adjacent vertebral bodies reduces the flexibility of the entire lumbar spine. The result is the appearance of pain and stiffness in the lower back, especially at the end of a hard day's work.

Cause

Degeneration of the intervertebral disc (DDD) is a natural aging process. Unfortunately, as the age increases, the intervertebral discs gradually lose their flexibility, elasticity and shock absorption. The ligaments around the disc (called the annulus) become fragile and easily torn. At the same time, the gelatinous soft part of the center of the disc (called the nucleus pulposus) begins to lose water and shrink. This series of disc injuries produces spurs that support the thickening of the ligaments of the spine, leading to degenerative lumbar arthritis.

an examination

Related inspection

Spinal MRI examination of bone and joint soft tissue CT examination

1, the most common symptom of degeneration of the intervertebral disc is waist pain. When the degeneration of the intervertebral disc causes compression of the nerve roots, the pain usually radiates to the legs or feet and may be accompanied by numbness and tingling. If there are signs of nerve root compression, some patients may have sciatica and lumbar pain, and sometimes lower limb weakness.

2, the diagnosis of intervertebral disc degeneration must first complete a physical examination, especially the examination of the lower and lower limbs. The doctor will check the flexibility, mobility, and other signs that may indicate nerve root compression. It is often necessary to check the strength and reflex activity of the muscle to determine if it is functioning properly. You usually need to fill out a form indicating when pain, numbness, tingling and weakness are present.

3. If the patient is seen for pain in the lower back, regular X-ray examination is necessary. If there is degeneration of the intervertebral disc, the X-ray will show a narrowing of the intervertebral space, which indicates that the disc is atrophied or ruptured. Bone hyperplasia occurs mostly at the edges of vertebral bodies and facets. X-rays can show this growth of the bones. Disc rupture and formation of callus result in a smaller space for accommodating nerve roots. The nerve roots penetrate the spinal canal through a bony channel called a nerve hole, which is particularly prone to stenosis.

4. In most cases, doctors will use MRI or CT to help diagnose lumbar disc degeneration. MRI can clearly show the location of disc herniation and nerve root compression. CT is often used to show the bone anatomy of the spine, so it can show the remaining space in the nerve hole and spinal canal.

Differential diagnosis

Differential diagnosis of intervertebral disc degeneration:

It should be differentiated from intervertebral disc dislocation, which refers to a pathological state caused by the nucleus pulposus of the intervertebral disc and part of the fibrous ring protruding to the surrounding tissue and compressing the corresponding spinal cord or spinal nerve root. It is related to factors such as degeneration and damage of the intervertebral disc. Waist 4/5, waist 5 / 1 is the most common part of disc herniation, followed by cervical vertebrae. There are three types of disc prolapse:

1 Central type: refers to those located in the center line;

2 posterior type: refers to those located in the spinal canal on both sides of the midline;

3 lateral type: refers to the prominent disc located outside the root canal, this type of spinal nerve root compression symptoms are heavy.

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