Origin of Spinal Degeneration
The number of spinal diseases has increased steadily over the last decades. This is mainly due to higher life expectancy and altered life style in the industrialized world. In addition, the continuous improvement of treatment programs contributes to that trend. Today, extensive spinal surgery is safely performed even in older patients since modern implant systems and high standard intensive care is available in specialized centers. Nevertheless, in most cases the patients can also be treated with conservative therapy, i.e. non- surgical, successfully. Ideally the modality of treatment is individually adapted to the magnitude of the illness in a phased therapy plan.
What is the Origin of Spinal Diseases?
The different parts of the spine consist of multiple motion segments. The term motion segment describes the anatomic unit of the disc and the adjacent vertebral connected by tapelike ligaments. The swelling pressure of the disc decreases with increasing age and the ligaments become relatively loose. The spinal motion segment develops instability. Now a natural compensatory mechanism tries to counteract this instability while the soft tissue becomes stronger, grows and partly also ossifies. Stress-depending sciatic pain is then frequently reported by the patients, because the neural structures are compressed by the degenerated tissue. Similar symptoms are presented in cases of a herniated disc, where the prolapsed nucleus of the disc is squeezing the spinal cord. Before therapy is being initiated, extensive diagnostics have to be performed. Most importantly, the stability of the motion segment has to be evaluated. It is also important for the spine surgeon to know whether back pain or sciatic pain is the predominant complaint.