The Natural History Of Degenerative Disc Disease

By David Akinpelu, MD

Osteoarthrosis of the spine, also known as spinal arthritis, encompasses a spectrum of disease states that includes degenerative disc disease, disc-osteophyte complexes, facet arthropathy, and spondylosis.

Studies have shown that oseoarthritic changes start to occur as early as 21 years of age. The determination of the speed of progression of these disease states often depends on other factors that include prior history of trauma, heavy wear and tear on the joints of spine as a result of spinal mal-alignment (e.g. scoliosis, lordosis or kyphosis), heavy manual labor, and contact sports to name a few.

Osteoarthrosis is a slowly progressive, non-inflammatory disease. When it affects the spine it can be very debilitating resulting in lost or diminished years of productivity. Recent studies have shown that the natural progression of degenerative disc disease can be significantly delayed by spinal decompression therapies such as IDD Therapy. Patients who have failed other forms of therapy including physical therapy and chiropractic therapy have a documented curative success rate of up to 93%.

The history of degenerative disc disease is divided into four stages. In the first two stages, there is little to no effect on the bony structure of the spine, however, in the second stage, there is loss of height of the vertebral discs associated with dehydration and thinning of the fibrous tissue of the outer layers of the disc.

In the third stage of degenerative disc disease, bony changes occur in which a disc-osteophyte complex ensues consisting of the additional formation of bony spurs at the edges of the vertebral bodies associated with further thinning of the disc material.

In stage four, there is a minimal amount of disc material left and severe bony changes with almost a bone on bone appearance. IDD therapy at this stage is of little or no effect. Patients with stage four disease will usually require artificial disc replacement or vertebral fusion. Pain management can be obtained through appropriate specialists in that field.

Understanding the pathogenesis and long-term outcome of the natural history of degenerative disc disease is useful in determining appropriate therapeutic options and appropriate timing of intervention to ensure a positive clinical therapeutic outcome.