Multilevel Degenerative Disc Disease

Degenerative disc disease occurs when individual discs in the spine break down, resulting in pain and stiffness. This disease, also known as Spondylosis, involves the intervertebral discs. Located between the individual vertebrae, the intervertebral discs are the spine's shock absorbers. When these discs degenerate, they stiffen, causing pain and restricting back movement.

Expert Insight

• Multilevel degenerative disc disease affects more than one vertebra. If one level is damaged, there is additional stress on the levels above. Multilevel degenerative disc disease is most likely to occur in the cervical spine (the neck) or the lumbar spine (lower back). This disease is very uncommon in the thoracic spine. The neck (cervical spine) has seven vertebrae, numbered C1 to C7. The low back (lumbar spine) has five vertebrae (L1 to L5). With multilevel degenerative disc disease, degeneration to one disc---for example the L5---the levels above sustain damage because of additional stress.

Causes

• Typically, multilevel degenerative disc disease occurs naturally as a result of the process of aging. Over time, wear and tear in the discs causes breakdown. The disease also can result from back trauma or infection. Smoking can contribute to degenerative disc disease because it decreases the amount of water in the discs, exacerbating disc degeneration. Finally, genetic factors can affect the disease, as some patients may be predisposed to excessive joint wear.

Symptoms

• Back pain is, of course, the most common symptom of multilevel degenerative disc disease. The pain is generally constant, but acute episodes of pain may occur. In addition, patients may experience increased pain when bending or lifting, increased pain during extended periods of sitting and decreased pain when walking, running or lying down.
  Patients should seek medical attention if pain persists. In some cases, discs may herniate or rupture, which may cause pain in the knees, legs or groin. Patients should seek immediate medical attention if back pain worsens or if they experience leg weakness, numbness or tingling in the legs or loss of bladder or bowel control.

Diagnosis

• Patients who experience back pain should contact a physician who specializes in treatment of the spine. Because it develops gradually, degenerative disc disease can be difficult to diagnose. A physician may easily diagnose a herniated disc, but it is more difficult to determine if degenerative disc disease caused the herniation. Physicians generally use imaging tests, such as x-ray or MRI, to diagnose multilevel degenerative disc disease.

Treatment

• Physicians primarily rely on conservative, non-operative treatment approaches, including physical therapy and/or anti-inflammatory medications. With multilevel degenerative disc disease, however, greater intervention may be necessary because the disease affects the entire spine. If the conservative measures described above fail to relieve pain, surgical intervention may be necessary. In early 2008, the Food and Drug Administration (FDA) approved release of an artificial disc, which generated excitement among patients and physicians.