Management of symptomatic lumbar degenerative disk disease.
Publication/Presentation Date
2-1-2009
Abstract
Symptomatic lumbar degenerative disk disease, or discogenic back pain, is difficult to treat. Patients often report transverse low back pain that radiates into the sacroiliac joints. Radicular or claudicatory symptoms are generally absent unless there is concomitant nerve compression. Physical examination findings are often unremarkable. Radiographic examination may reveal disk space narrowing, end-plate sclerosis, or vacuum phenomenon in the disk; magnetic resonance imaging is useful for revealing hydration of the disk, annular bulging, or lumbar spine end-plate (Modic) changes in the adjacent vertebral bodies. The use of diskography as a confirmatory study remains controversial. Recent prospective, randomized trials and meta-analyses of the literature have helped expand what is known about degenerative disk disease. In most patients with low back pain, symptoms resolve without surgical intervention; physical therapy and nonsteroidal anti-inflammatory drugs are the cornerstones of nonsurgical treatment. Intradiskal electrothermal treatment has not been shown to be effective, and arthrodesis remains controversial for the treatment of discogenic back pain. Nucleus replacement and motion-sparing technology are too new to have demonstrated long-term data regarding their efficacy.
Volume
17
Issue
2
First Page
102
Last Page
111
ISSN
1067-151X
Published In/Presented At
Madigan, L., Vaccaro, A. R., Spector, L. R., & Milam, R. A. (2009). Management of symptomatic lumbar degenerative disk disease. The Journal of the American Academy of Orthopaedic Surgeons, 17(2), 102–111. https://doi.org/10.5435/00124635-200902000-00006
Disciplines
Business Administration, Management, and Operations | Health and Medical Administration | Management Sciences and Quantitative Methods
PubMedID
19202123
Department(s)
Administration and Leadership
Document Type
Article