Abstract
The degenerative disease of the intervertebral disc and back pain are chronic conditions that are caused by several factors and represent an important cause of morbidity and mortality in everyday clinical practice. The study aims to summarize the updated evidence regards epidemiology, pathophysiology, clinical manifestation, diagnosis, and management of degenerative disc diseases. The incidence of low back pain, which is the main symptom in Intervertebral Disc (IVD) disease, varies widely among different reports. It is the fifth most common cause for the visit to the doctor and affects 7.6 to 37% of patients. IVD degeneration is attributed to a complex interplay between environmental and genetic factors. DDD is a process that includes a progressive decrease in disk nutrient supply and changes in extracellular matrix (ECM) composition, which weakens the tissue strength and alters the cell metabolism.Degenerative lumb disc disease patients typically present with mechanical lower back pain, which is worse on forward flexion and when carrying heavy load. The pain is relieved with rest. Diagnosis of DDD is done by various methods, computed tomography (CT) scan, magnetic resonance imaging (MRI), and provocative discography. These methods should be used in conjunction with the patient history, physical examination and specific biomarker to monitor the response to treatment. There are three major lines of management of DDD; Treatment Options for Relief of Pain in Conservative Therapy.Treatment with Aims of Restoration, Repair, and Regeneration of Intervertebral Disc Diseases: Molecular Therapy. Reconstructive Strategies: Percutaneous Intervertebral Disc Techniques. Definitive Treatment for Intervertebral Disc Diseases :( surgical management).
Highlights
Low back pain is the most frequent chronic pain condition, leading to disability, increased risk of falling, and depression, as well as substantial societal costs, impairment, and health consequences [1]
Disc desiccation [low signal intensity on T2-weighted magnetic resonance imaging (MRI)], which is a common finding in adults irrespective of symptoms, to particular symptomatic disorders, like disc herniation with concordant radiculopathy [2]
The degenerative disease of the intervertebral disc and back pain are chronic conditions that are caused by several factors and represent an important cause of morbidity and mortality in everyday clinical practice [3]
Summary
Low back pain is the most frequent chronic pain condition, leading to disability, increased risk of falling, and depression, as well as substantial societal costs, impairment, and health consequences [1]. The degenerative disease of the intervertebral disc and back pain are chronic conditions that are caused by several factors and represent an important cause of morbidity and mortality in everyday clinical practice [3]. It is a common condition characterized by the breakdown (degeneration) of one or more of the discs that separate the bones of the vertebrae, causing pain in the back or neck as a consequence of the cell-mediated response to multifactorial contributions, such as genetics, micro/macro trauma, accelerated age-related changes, inflammation, local nutritional deficiency, and vascular factors, leading to excess catabolic over anabolic responses. Treatment strategies need to consider age of presentation, comorbidities, severity of IVD, neural elements compression and stability of the spinal column, many of the restorative and reconstructive management strategies are still at the early stages of laboratory experimental and animal trials, with clinical efficacy yet to be proven [5]
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