Degenerative Disk Disease: Stages Of Degeneration, Low Back Pain, And Insights On Intradiskal Therapies

Abstract

We believe the term acquired degenerative intervertebral dysfunction (ADIVD) more accurately takes into account the histological, biomechanical, and clinical features of lumbar spine degeneration than by simply labeling these patients as having “instability.” Treatment indications are a function of the four stages of a new classification for loss of stability in the degenerative lumbar spine described here. Among available intradiskal treatments, percutaneous radiofrequency techniques can be used to treat early stage diskogenic low back pain and patients with contained disk herniation as an alternative to diskectomy. Using a “memory-coiling spiral,” nucleus pulposus implant restores normal spine kinematics and maintains disk height. The results of a multicenter European study indicate that this implant design is sound, tangible, and effective, but can only be used if the outer annulus is intact.