Degenerative spine disease treatment
🧠1. Conservative (Non-Surgical) Management
Most patients benefit from non-operative treatments, especially in early stages.
🔹 Medications
NSAIDs (ibuprofen, naproxen): reduce inflammation and pain
Acetaminophen: for pain control
Muscle relaxants: if muscle spasms are present
Neuropathic pain agents: gabapentin, pregabalin, duloxetine
🔹 Physical Therapy
Strengthening core muscles
Improving posture and flexibility
Aerobic conditioning (e.g., swimming, cycling)
🔹 Lifestyle Modifications
Weight loss
Smoking cessation (smoking accelerates disc degeneration)
Ergonomic improvements at work/home
🔹 Interventional Pain Management
Epidural steroid injections
Facet joint injections
Medial branch blocks or radiofrequency ablation
🧠2. Surgical Treatment Indicated when there is:
Neurological deficits (e.g., weakness, myelopathy)
Persistent disabling pain despite 6+ months of conservative therapy
Structural instability or deformity (e.g., spondylolisthesis, scoliosis)
🔹 Common Surgical Options Discectomy – removal of herniated disc material
Laminectomy / Laminotomy – decompression of spinal canal
Foraminotomy – decompresses exiting nerve roots
Spinal Fusion – stabilizes spine by fusing vertebrae
Disc Replacement (cervical or lumbar in selected cases) – preserves motion
🔹 Minimally Invasive Techniques Smaller incisions, less tissue damage
Shorter recovery times
Options: endoscopic discectomy, MIS-TLIF (minimally invasive transforaminal lumbar interbody fusion)
🧠3. Advanced & Adjunctive Therapies Neuromodulation: spinal cord stimulation for chronic pain
Regenerative medicine (under investigation): PRP, stem cell injections
Orthobiologics may assist in spinal fusion healing
✅ Tailored Approach The treatment should always be personalized, involving:
Imaging (MRI, CT, X-rays)
Clinical correlation
Patient preferences and goals
The standard treatment for a variety of advanced degenerative spinal pathologies is arthrodesis of the affected motion segments. This often follows a procedure of direct or indirect decompression of the afflicted neural tissue. Arthrodesis, or joint fusion, is often warranted following decompression because of mechanical instability of the joint, either as a result of degenerative changes leading up to surgical intervention or due to tissue disruption caused by the decompression procedure itself. Fusion of the index level is aided by a graft material consisting of either a synthetic bone substitute or bony tissue derived from the patient (autograft) or a donor (allograft). Internal fixation devices, consisting of such implants as screws, rods, plates and interbody spacers, have emerged as useful adjuncts to the fusion graft by providing immobilization of the joint during the fusion process.
The rate of pseudarthrosis, or the failure of successful fusion, has been reported at a variety of ranges depending on factors such as the specific pathology treated, the surgical technique, the technique used to assess the non-union, the number of levels fused and the presence of any metabolic abnormalities 1) 2) 3).