Degenerative Disc Disease

Degenerative disc disease (DDD) is a condition that results in intervertebral disc deterioration. As a disc deteriorates, it may press on the adjacent spinal nerves, which causes radiating pain down a leg or arm. It most commonly leads to persistent back pain due to irritation of the disc’s nerve endings.


What are intervertebral discs?


Intervertebral discs lie between the vertebrae, which are the spinal bones. These cushioning discs are filled with a watery, gel-like substance. The center portion should contain around 80% water, but with DDD, the water content decreases.  


How many people are affected by low back pain and DDD?


In America, low back pain is a common musculoskeletal problem, and it is the third most frequently reported symptom. Around 20% of all physician visits are related to back pain. In a recent study involving almost 1,000 participants, researchers found that the prevalence of DDD in men under 50 was 71%, and for women, it was 77% in that age group. For men and women over the age of 65 years, DDD affects 90% of people. Thankfully, most people with DDD are not symptomatic.


What causes degenerative disc disease?


When discs lose water content, they become less flexible and shorter. Once discs are injured, the spine cannot tolerate stress, which often leads to other problems. Normally, discs act as a cushion between the vertebrae. The cause of disc degeneration is not always known. There are genetic causes and socioeconomic causes such as smoking or repetitive stress.


What are the symptoms of DDD?


For many people, degenerative disc disease does not cause any symptoms. However, the most common symptom associated with DDD is back pain, which can gradually increase over time. The pain may radiate (shoots) down an arm or leg, which depends on the location of the DDD. 


How is degenerative disc disease diagnosed?


The doctor can diagnose degenerative disc disease by performing a physical examination and with diagnostic imaging tests. X-rays are used to show bone deterioration, and a magnetic resonance imaging (MRI) scan will show damage to the discs and soft tissues. MRI is the best test, as the loss of water leads to a black appearance on MRI and a loss of height.


How is degenerative disc disease treated?


Treatment of degenerative disc disease includes:


  • Physical therapy – The therapist can use strengthening exercises to alleviate pain and improve flexibility. In addition, aquatic therapy is used to relax the back and learn proper body mechanics. Modalities used to relieve pain include massage, heat, ice, and electrical stimulation. Bracing involves a simple corset or rigid plastic jacket that improves posture.


  • Medications – Many medications are used to treat the pain and nerve symptoms associated with DDD. These include nonsteroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, antidepressants, and anticonvulsants.


  • Epidural injections – The injection is done by inserting a needle into the epidural space (around the thecal sac) and then injecting a steroid medication. This will reduce inflammation in the spinal canal.


  • Trigger point injections – A small needle is used to injection the muscles with lidocaine. This is used to relieve tenderness, tension, and stress.


  • Transcutaneous electrical stimulation (TENS) – A small unit is used to provide electrical stimulation to painful areas of the back. The device uses low current electrical charge to block transmission of pain signals.


  • Spinal fusion – if DDD fails conservative treatment, a fusion procedure may be indicated. The Inspired Spine OLLIF procedure is the top minimally invasive keyhole surgery available to minimize complications and maximize outcome!




Bressler HB, Keyes WJ, Rochon PA, et al. (1999). The prevalence of low back pain in the elderly: a systematic review of the literature. Spine, 24:1813–9.

Brodke DS & Ritter SM (2005). Nonsurgical management of low back pain and lumbar disk degeneration. Instr Course Lect, 54:279–86.

Teraguchi M, Yoshimura N, Hashizume H, et al. (2014). Prevalence and distribution of intervertebral disc degeneration over the entire spine in a population-based cohort: the Wakayama Spine Study. Osteoarthritis and Cartilage, 22(1) 104-110.

Benefits of Inspired Spine Advanced Minimally Invasive Spine Surgery for Degenerative Disc Disease

Both open and Inspired Spine Advanced Minimally Invasive lumbar fusion surgeries can be used to treat patients with degenerative spine disease, including degenerative disc disease (DDD). Degenerative disc disease surgery is often a last resort for patients who have severe back pain that restricts ability to perform daily activities.


How common is degenerative disc disease?


According to a recent review of clinical studies, more than 90% of people age 65 years and older have some level of degenerative disc and facet pathology. In addition, presence of DDD on radiographs was associated with 2-fold greater odds of having chronic low back pain. Age-related degenerative changes of the spine contribute to lumbar spinal stenosis. Surgery has been proven to decrease pain and improve functional status for people with spinal stenosis and degenerative disc disease.


Does Inspired Spine Advanced Minimally Invasive spine surgery for DDD work?


In a recent clinical study, researchers evaluated long-term clinical durability and safety of patients who had Inspired Spine Advanced Minimally Invasive transforaminal lumbar interbody fusion (MIS-TLIF) for DDD. The outcome measures were return to work time, hospital stay time, Oswestry Disability Index, visual analog pain scores, fusion status, pain medication use, and reoperation rate. Researchers found that MIS-TLIF for DDD was a safe, effective procedure that offered long-term clinical durability.


What Inspired Spine Advanced Minimally Invasive spine procedures are used to treat degenerative disc disease?


For DDD, several Inspired Spine Advanced Minimally Invasive spine surgeries can help. These include:


  • Decompression with interlaminar stabilization – This involves decompression of the affected area and insertion of a coflex device, which stabilizes the spine.


  • Anterior cervical discectomy fusion – Performed through a small incision at the front of the neck, the surgeon removes the affected disc and stabilizes the surrounding vertebrae.


  • Posterior cervical fusion – A small incision is made at the back of the neck and vertebrae are fused for stability.


  • Transforaminal lumbar interbody fusion – To relieve nerve compression and stabilize the spine, the surgeon re-establishes proper disc height using bone grafts.


  • Lateral lumbar interbody fusion – This involves making an incision on the side of the back and removing damaged disc of the lower spine. Bone graft fusing of two adjacent vertebrae is used to offer spine stability.


What are some advantages of the Inspired Spine Advanced Minimally Invasive spine surgery techniques?


The mini-open approach to degenerative disc disease surgery offers several advantages over traditional, open spine surgeries. Unlike open procedures, Inspired Spine Advanced Minimally Invasive operations can be done on an outpatient basis, and patients avoid a lengthy recovery. In addition, there is less damage to the muscles that surround the spine, so less pain is involved.


Patients tend to have less infection, smaller scars, and better post-operative outcomes with the Inspired Spine Advanced Minimally Invasive spine surgeries. Many clinical studies have shown faster return to activities, decreased narcotic use, and improved cosmesis after Inspired Spine Advanced Minimally Invasive spine surgery. Patients who have Inspired Spine Advanced Minimally Invasive surgery for lumbar decompression also have fewer complications after the procedure.


How does Inspired Spine Advanced Minimally Invasive spine surgery compare to open, traditional surgery for DDD?


Compared to traditional procedures, Inspired Spine Advanced Minimally Invasive surgery was pursued to reduce tissue trauma during surgery. Because there is less estimated blood loss and tissue damage, the patient has less postoperative pain and a faster recovery with mini-open spine surgery. Inspired Spine Advanced Minimally Invasive techniques reduce muscle crush injury rates, prevent disruption of tendon attachment at important muscle sites and spinous processes, and minimize soft tissue trauma.




Hicks GE, Morone N, & Weiner DK (2009). Degenerative Lumbar Disc and Facet Disease in Older Adults: Prevalence and Clinical Correlates. Spine, 34(12), 1301-1306.


Rouben D, Casnellie M, & Ferguson M (2011). Long-term durability of minimal invasive posterior transforaminal lumbar interbody fusion: a clinical and radiographic follow-up. J Spinal Disord Tech, 24(5), 288-296.


Skovrli B, Gilligan J, Cutler HS, & Qureshi SA (2015). Inspired Spine Advanced Minimally Invasive procedures on the lumbar spine. World J Clin Cases, 3(1), 1-9.