Degenerative disc disease Flashcards
What is degenerative disc disease?
Natural deterioration of the intervertebral disc structure, they become weak and then collapse
What makes degenerative disc disease more likely to occur?
Progressive dehydration of the nucleus pulposus, daily activities causing tears in the annulus fibrosis, pathology causing instability like fractures, surgery or osteoporosis
What are the three stages of degenerative disc disease?
dysfunction, instability and restabilisation
What is meant by dysfunction in degenerative disc disease?
outer annular tears and separation of the end plate, cartilage destruction and facet synovial reaction
What is meant by instability in degenerative disc disease?
disc resorption and loss of disc space height, along with facet capsular laxity, can lead to subluxation and spondylolisthesis
What is meant by destabilisation in degenerative disc disease?
Degenerative changes lead to osteophyte formation and canal stenosis
What are the early symptoms of degenerative disc disease?
local spinal tenderness, contracted paraspinal muscles, hypo mobility, painful extension of the back or neck
What are the symptoms when instability occurs in degenerative disc disease?
pain will become more severe, and include radicular leg pain or paraethesia
What is Lasegue sign?
Straight Raising the extended leg, will be positive with a degenerative disc disease
What are further progressive symptoms of degenerative disc disease?
worsening muscle tenderness, stiffness, reduced movement and scoliosis
What is a differential diagnosis of degenerative disc disease?
Cauda equina syndrome, infection like disci tis, malignancy
When should investigations should be done for degenerative disc disease?
Red flags, radiculopathy with pain for more than 6 months, spinal cord compression, imaging would alter management
If degenerative disc disease does need investigations, what would it be and what would it show?
MRI spine, signs of degeneration, reduction of disc height, annular tears, endplate changes
What is the management of degenerative disc disease?
highly variable and patient dependant, analgesia, encourage mobility and physiotherapy, pain clinic
