Degeneration of the inner part of the disc tissue manifest itself with a back pain, and is called degenerative disc disease. This condition is different from the herniation of disc tissue (disc herniation). In radiologic MRG examination, analysis of the disc tissue at T2 may show signs with blackening (black disc); and when the degeneration progresses, that blackening in the disc increases and a decrease is observed in the height of the disc between the vertebrae. It’s a painful condition. It is usually at the level of single disk. Diagnosis is made with clinical examinations, MRG scans and discography.
If the painful process of degenerative disc disease persists for a period longer than 6 months, and if the pain cannot be relieved despite physical therapy and epidural steroid injections, surgical intervention may be needed. It is because low back pain is an unsettling condition encountered as a result of a degenerative disc disease that reduces the quality of life. Today, there are two preferred surgical treatment procedures in the world. The first procedure is to make posterior dynamic stabilization between the vertebrae only, where the unhealthy disc is located, while preserving the disc tissue. By this means, the load on the degenerated disc will be eliminated or at least decreased; and therefore, the low back pain will be relieved. In the literature, this procedure has been reported to preserve the disc and achieve a radiological improvement in cases of an unadvanced disc defects. The second procedure is fusion surgery. In this procedure, the degenerated disc tissue is completely removed, and after placing bone tissue or cages in its place, a fusion (freezing) process is carried out. With this intervention, a posterior stabilization again is added to surgery.
Disk herniations constitute a different condition. In this condition, the tissue called nucleus pulposus in the inner part of the disc tissue may tear the tissue annulus and press the nerve tissues in the canal. In conclusion, it is a condition resulting in loss of strength and/or sensation in the leg or foot. If there is a significant neurological deficit (Severe pain that does not respond to medical treatment, drop foot, urinary incontinence, loss of strength and sensation in both legs) caused by disk herniation, an urgent surgical intervention may be needed; however, in situations other than this, usually a medication and physical therapy are administered for a period of 4-6 weeks, and if an improvement cannot be achieved or if the condition get worse despite these, a surgical intervention may be considered. The microsurgical procedures and discectomy are the standard procedures in surgical treatment.