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Intervertebral Disk Disease

The symptoms of back pain derived from disk degeneration are usually insidious in onset. Frequently, the patient will relate recurrent episodes of "stiff back". Occasionally, the onset is sudden, dramatic, unanticipated, and unrelated to any precipitating activity. The patient may awaken one morning with an extremely painful stiff back. During the passage of the day, the pain may radiate to the buttock and leg region, rendering the patient painfully immobile. Such episodes generally subside within 10 to 14 days with or without treatment but have an unfortunate tendency to recur.

Before any treatment, the diagnosis should be established with the knowledge of pathogenesis, and the clinical examination. 

The treatment decision in lumbar disk disease is based on a clear understanding of four factors:

  • Accurate diagnosis. Is this a soft tissue syndrome, a discogenic problem, a root encroachment problem, a cauda equina problem, or a combination of various syndromes?
  • Anatomical level.
  • Patient selection. Is he or she accurately reporting the disability, or is there some embellishment for medical-legal or compensation purposes?
  • Functional limitation. Is this collection of minor symptoms of nuisance value to the patient, or is there chronic cauda equina compression to the point that the patient needs aids for ambulation?

Imaging modalities play an essential role in accurate diagnosis especially before invasive treatment. Imaging strategies for evaluating disk diseases include or combine usually Magnetic Resonance (MR) who has become the primary imaging modality, Computed Tomography (CT), plain films.

The spectrum of disk diseases will be reviewed including:

  • Degenerative disc disease (DDD)
  • Disk Herniations
  • Diskitis
  • Postoperative disk and spine