Degenerative Disc Disease Treatment

This common condition is a natural part of aging, but at an accelerated rate. Spinal discs pad vertebrae in your spine and absorb shock. Wear and tear may cause the discs to lose their shape and become weak -- sometimes putting pressure on nerves. Eventually your discs can bulge or even rupture, causing severe pain and potential nerve compression. As it progresses, disc disease can lead to spine arthritis conditions like spondylosis, radiculopathy (pinched nerve), spondylolisthesis (a slipping vertebra), and other spinal deformities.

A conservative degenerative disc disease treatment approach is the first step, and it controls pain for most people. In addition to rest and heat or ice, your back doctor may suggest:

Medication
Besides over-the-counter pain relievers, nerve medications may help relieve nerve symptoms, and short-term steroids can help reduce inflammation. Medication is typically combined with physical therapy as your first step. 

Physical Therapy
A trained physical therapist guides you in exercises and stretches designed to strengthen your back, improve your balance and flexibility, and improve range of motion -- all benefits that can alleviate your pain.

Chiropractic Care
A skilled chiropractor uses spinal manipulation and other manual methods to help relieve back pain and other symptoms such as numbness and tingling, loss of strength, or pain in the arms or legs. These hands-on techniques stretch and move the spine to restore mobility to joints restricted by injury or repetitive stress, such as sitting without proper back support. Our chiropractors can also teach you exercises for improving strength and flexibility and incorporating safe movements and proper posture into your daily activities.

Spine Injections
Epidural steroid injections treat inflammation and pain right at the source -- your pinched nerve roots or arthritic joints. Using X-ray imaging as a guide, your doctor numbs your skin and places a needle into the pain source in your spine. You’ll feel pressure during this procedure. The medicine usually begins working within a few days to a week. You’ll be able to return to normal activities the following day. We give these injections in a special, sterile suite. 

Bracing 
In some cases, a rigid or semi-rigid back brace may provide comfort by stabilizing your spine. 

Other Treatments
Some people find relief from acupuncture, chiropractic care, or aquatic therapy. Nutritionists and weight loss specialists can help manage disc problems caused by obesity. We offer these treatments as a complement to your regular treatment plan, not as a substitute.

If you require spine surgery for disc problems, we use minimally invasive approaches and consider outpatient surgery whenever possible.

Microdiscectomy
For this minimally invasive procedure, surgeons work through a small incision to remove a portion of disc and bone to relieve pressure on a nerve. You may need general anesthesia, and you will probably be able to go home within 24 hours. You’ll need to limit activities for 6 to 12 weeks after surgery.

Laminectomy
Surgeons remove the back part (the lamina) of one or more vertebrae to create more space in the spinal canal and to relieve pressure on nerves or the spinal cord. This procedure may require general anesthesia and a short hospital stay.

Spinal Fusion 
We offer complex spinal reconstruction (or spinal fusion) surgery to correct spinal problems. These procedures stabilize your spine with rods and screws and fuse together the vertebrae. Whenever possible, we use the least-invasive techniques available so that you can recover faster and experience less pain and fewer complications. 

Disc Replacement (Total Disc Arthroplasty)
This newer option replaces your damaged disc with an artificial disc. This procedure may require general anesthesia. You should be able to go home the same day as surgery or the following day. You’ll need to limit activities for several weeks to months.

Striving for the Best
Research shows that hospitals and surgeons who perform more surgeries tend to have better outcomes. Our surgical team performs more than 3,000 spine surgeries every year and sees over 30,000 patients. We collect data and compare our outcomes to regional and state centers.

A Team of Specialists
In addition to neurosurgeons and orthopaedic surgeons, your team may include physiatrists (physical medicine and rehabilitation doctors who specialize in conservative spine care), physical therapists, psychologists, pain management experts, an acupuncturist, a chiropractor, and others -- all of whom work with you to alleviate the pain and inflammation caused by your disc condition.

Offering Advanced Techniques
In addition to offering the latest surgical options, including awake surgery, we also provide expertise in specialty care, spine reconstruction, and more. Our operating rooms are equipped with technologies that provide real-time feedback. These systems help avoid the need for extra imaging after surgery, exposing you to less post-operative radiation, and allow for more surgical accuracy than ever before.

• We use imaging technology that give spine surgeons detailed, 3D pictures and video of your spine.
• Duke was the first in the U.S. to offer the Airo Mobile Intraoperative CT scan, which provides real-time imaging and more flexibility in the operating room.
• Our surgeons may also use a sophisticated navigation system -- similar to GPS for your body -- that helps them avoid vital nerves and other structures.
• A specialized neuromonitoring team tracks spinal cord function in real time to further reduce the risk of injury.

Personalized Treatment Plans
We aim to help you avoid surgery, if possible. That’s why our approach involves a combination of treatments to target the cause of your pain and improve symptoms. If you are a candidate for surgery, we use the least-invasive surgical techniques whenever possible, so you recover quickly and experience less pain and fewer complications.