chapter  1
17 Pages

Intervertebral Disc Degeneration in Clinics

Therapeutic Challenges
WithPedro Santos Silva, Paulo Pereira, Rui Vaz

Lumbar degenerative disc disease (DDD) findings in imaging studies are well recognized, and there are several classifications of disc degeneration for radiographs, computed tomography scans, and magnetic resonance imaging (MRI). In clinical practice, the differential diagnosis between specific, nonspecific Low back pain (LBP), and radicular pain is a primary concern. Specific causes of LBP are fractures, tumors, infection, and inflammatory diseases. Interventional treatments for LBP are still controversial and should be reserved only for patients who failed to improve with time and appropriate conservative management. Guidelines for the management of LBP strongly recommend conservative treatments as the first approach. Initial management includes medication and paracetamol, nonsteroidal anti-inflammatory drugs, and muscle relaxants that may be used for short-term treatment. Lumbar segment arthrodesis, or fusion, is the reference treatment for patients with lumbar DDD who failed all other treatments and in whom the intensity of pain and reduction of quality of life are so severe that surgical intervention is considered.