As a leading expert in spine surgery as well as minimally invasive spinal surgery, Dr. John D. Lipani has several years of specialized training and experience to provide state-of-the-art neurosurgery in New Jersey.
Discogenic back pain occurs as the architecture of the spinal discs gradually degenerate over time. As one of the most prevalent causes of chronic back pain, the most frequent discogenic back pain symptoms are lower back pain and spasms. In most cases, the pain is made worse by bending, sitting or prolonged standing and is often relieved to some degree by lying down. Leg pain caused by irritation of the nerves in the lower back (radiculopathy) may also accompany discogenic back pain.
Sometimes discogenic back pain occurs with spinal stenosis, a narrowing of the canal through which the spinal cord runs. Spinal stenosis can put pressure on your spinal cord and result in neurologic deficits. Similarly, facet joint (joints within the spinal column between the vertebral bodies) disorders can result in recurrent, disabling lower back and neck problems. A combination of discogenic back pain, spinal stenosis and facet joint degeneration can lead to worsening neck or back pain as well as nerve root pain, sensory loss and weakness.
The lower spine has five vertebrae with soft discs in between. Each of these discs is composed of a tough outer ring that surrounds a soft center. These discs consist predominately of water when we are young; however, as we age, the discs lose hydration. This makes the discs more susceptible to cracking and fissures, leading to inflammation and pain associated with discogenic back pain.
The diagnosis of discogenic back pain is often difficult because disc degeneration is a normal part of the aging process. Therefore, a number of discs may appear to be degenerative on MRI, but the question is whether a specific disc is actually a pain generator for the patient. A common test used to help diagnose discogenic back pain is called a discogram or discography. This test is performed by placing a needle into the affected disc and injecting a small amount of contrast dye into the disc. This offers information on the structure of the disc and determines if the disc is a pain source.
If conventional, non-surgical treatments are unsuccessful, discogenic back pain surgery is available. The goal of the surgery is to remove the offending disc and replace it with a bone plug. Essentially, Dr. Lipani will remove the offending disc, replace it with a bone blug and fuse the adjacent vertebral bodies together to permanently eliminate the pain generator. This requires placement of internal hardware to secure the spinal column while the fusion takes place. Alternatively, a titanium artificial disc may be used in place of the bone plug. This option preserves motion between the vertebrae and in some cases, may be chosen to prevent other discs from further degeneration. This procedure is extremely successful in appropriately selected patients.
For more information about discogenic back pain treatment, contact the office of Dr. John D. Lipani for more information at (609)-890-3400 today!
