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Degenerative Disc Disease
Jeffrey S. Ross, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Synonyms

              • Degenerative disc disease (DDD), disc degeneration, spondylosis
            • Definitions

              • Generalized and multifactorial process affecting discovertebral unit leading to biomechanical/morphologic alterations
              • Asymptomatic or associated with back/neck pain ± radiculopathy

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • MR Findings

                      • Nonvascular Interventions

                        • Nuclear Medicine Findings

                          • Other Modality Findings

                            • Imaging Recommendations

                              DIFFERENTIAL DIAGNOSIS

                                PATHOLOGY

                                • General Features

                                  • Staging, Grading, & Classification

                                    • Gross Pathologic & Surgical Features

                                      • Microscopic Features

                                        CLINICAL ISSUES

                                        • Presentation

                                          • Demographics

                                            • Natural History & Prognosis

                                              • Treatment

                                                DIAGNOSTIC CHECKLIST

                                                • Consider

                                                  • Image Interpretation Pearls

                                                    Selected References

                                                    1. Jacobs WC et al: The evidence on surgical interventions for low back disorders, an overview of systematic reviews. Eur Spine J. 22(9):1936-49, 2013
                                                    2. Kauppila LI: Atherosclerosis and disc degeneration/low-back pain--a systematic review. Eur J Vasc Endovasc Surg. 37(6):661-70, 2009
                                                    3. Hadjipavlou AG et al: The pathophysiology of disc degeneration: a critical review. J Bone Joint Surg Br. 90(10):1261-70, 2008
                                                    4. Jandial R et al: Stem cell-mediated regeneration of the intervertebral disc: cellular and molecular challenge. Neurosurg Focus. 24(3-4):E21, 2008
                                                    5. Walker J 3rd et al: Discography in practice: a clinical and historical review. Curr Rev Musculoskelet Med. 1(2):69-83, 2008
                                                    6. Modic MT et al: Lumbar degenerative disk disease. Radiology. 245(1):43-61, 2007
                                                    7. Tow BP et al: Disc regeneration: a glimpse of the future. Clin Neurosurg. 54:122-8, 2007
                                                    8. Urban JP et al: Pathophysiology of the intervertebral disc and the challenges for MRI. J Magn Reson Imaging. 25(2):419-32, 2007
                                                    9. Boos N et al: Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine. 27(23):2631-44, 2002
                                                    10. Moore KR et al: Degenerative disc disease treated with combined anterior and posterior arthrodesis and posterior instrumentation. Spine. 27(15):1680-6, 2002
                                                    11. Frobin W et al: Height of lumbar discs measured from radiographs compared with degeneration and height classified from MR images. Eur Radiol. 11(2):263-9, 2001
                                                    12. Pfirrmann CW et al: Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 26(17):1873-8, 2001
                                                    13. Weishaupt D et al: Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology. 218(2):420-7, 2001
                                                    14. Beattie PF et al: Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance imaging. Spine. 25(7):819-28, 2000
                                                    15. Luoma K et al: Low back pain in relation to lumbar disc degeneration. Spine. 25(4):487-92, 2000
                                                    16. Jensen MC et al: Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 331(2):69-73, 1994
                                                    17. Modic MT et al: Magnetic resonance imaging in the evaluation of low back pain. Orthop Clin North Am. 22(2):283-301, 1991
                                                    18. Modic MT et al: Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 166(1 Pt 1):193-9, 1988
                                                    Related Anatomy
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                                                    Related Differential Diagnoses
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                                                    References
                                                    Tables

                                                    Tables

                                                    KEY FACTS

                                                    • Terminology

                                                      • Imaging

                                                        • Top Differential Diagnoses

                                                          • Pathology

                                                            • Clinical Issues

                                                              TERMINOLOGY

                                                              • Synonyms

                                                                • Degenerative disc disease (DDD), disc degeneration, spondylosis
                                                              • Definitions

                                                                • Generalized and multifactorial process affecting discovertebral unit leading to biomechanical/morphologic alterations
                                                                • Asymptomatic or associated with back/neck pain ± radiculopathy

                                                              IMAGING

                                                              • General Features

                                                                • Radiographic Findings

                                                                  • Fluoroscopic Findings

                                                                    • CT Findings

                                                                      • MR Findings

                                                                        • Nonvascular Interventions

                                                                          • Nuclear Medicine Findings

                                                                            • Other Modality Findings

                                                                              • Imaging Recommendations

                                                                                DIFFERENTIAL DIAGNOSIS

                                                                                  PATHOLOGY

                                                                                  • General Features

                                                                                    • Staging, Grading, & Classification

                                                                                      • Gross Pathologic & Surgical Features

                                                                                        • Microscopic Features

                                                                                          CLINICAL ISSUES

                                                                                          • Presentation

                                                                                            • Demographics

                                                                                              • Natural History & Prognosis

                                                                                                • Treatment

                                                                                                  DIAGNOSTIC CHECKLIST

                                                                                                  • Consider

                                                                                                    • Image Interpretation Pearls

                                                                                                      Selected References

                                                                                                      1. Jacobs WC et al: The evidence on surgical interventions for low back disorders, an overview of systematic reviews. Eur Spine J. 22(9):1936-49, 2013
                                                                                                      2. Kauppila LI: Atherosclerosis and disc degeneration/low-back pain--a systematic review. Eur J Vasc Endovasc Surg. 37(6):661-70, 2009
                                                                                                      3. Hadjipavlou AG et al: The pathophysiology of disc degeneration: a critical review. J Bone Joint Surg Br. 90(10):1261-70, 2008
                                                                                                      4. Jandial R et al: Stem cell-mediated regeneration of the intervertebral disc: cellular and molecular challenge. Neurosurg Focus. 24(3-4):E21, 2008
                                                                                                      5. Walker J 3rd et al: Discography in practice: a clinical and historical review. Curr Rev Musculoskelet Med. 1(2):69-83, 2008
                                                                                                      6. Modic MT et al: Lumbar degenerative disk disease. Radiology. 245(1):43-61, 2007
                                                                                                      7. Tow BP et al: Disc regeneration: a glimpse of the future. Clin Neurosurg. 54:122-8, 2007
                                                                                                      8. Urban JP et al: Pathophysiology of the intervertebral disc and the challenges for MRI. J Magn Reson Imaging. 25(2):419-32, 2007
                                                                                                      9. Boos N et al: Classification of age-related changes in lumbar intervertebral discs: 2002 Volvo Award in basic science. Spine. 27(23):2631-44, 2002
                                                                                                      10. Moore KR et al: Degenerative disc disease treated with combined anterior and posterior arthrodesis and posterior instrumentation. Spine. 27(15):1680-6, 2002
                                                                                                      11. Frobin W et al: Height of lumbar discs measured from radiographs compared with degeneration and height classified from MR images. Eur Radiol. 11(2):263-9, 2001
                                                                                                      12. Pfirrmann CW et al: Magnetic resonance classification of lumbar intervertebral disc degeneration. Spine. 26(17):1873-8, 2001
                                                                                                      13. Weishaupt D et al: Painful lumbar disk derangement: relevance of endplate abnormalities at MR imaging. Radiology. 218(2):420-7, 2001
                                                                                                      14. Beattie PF et al: Associations between patient report of symptoms and anatomic impairment visible on lumbar magnetic resonance imaging. Spine. 25(7):819-28, 2000
                                                                                                      15. Luoma K et al: Low back pain in relation to lumbar disc degeneration. Spine. 25(4):487-92, 2000
                                                                                                      16. Jensen MC et al: Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 331(2):69-73, 1994
                                                                                                      17. Modic MT et al: Magnetic resonance imaging in the evaluation of low back pain. Orthop Clin North Am. 22(2):283-301, 1991
                                                                                                      18. Modic MT et al: Degenerative disk disease: assessment of changes in vertebral body marrow with MR imaging. Radiology. 166(1 Pt 1):193-9, 1988