You are here

Lumbar Degenerative Disc Disease 722.52

 

synonyms:

Lumbar DDD ICD-9

  • 722.52 (intervertebral disc disorders; lumbar intervertebral disc)

Lumbar DDD Etiology / Epidemiology / Natural History

  • Includes lumbar spondylosis and isloated disk resorption, with degerative chages detectable on plain xrays.
  • Associated with repetitive flexion and extension activites such as gymnastics, incidence of DDD increases with length of time athletes competes in gymnastics; up to 63% for Olympic gymnasts.

Lumbar DDD Anatomy

Lumbar DDD Clinical Evaluation

  • Midline back pain; referred pain to the sacroiliac joints and posterior thighs. Buttock/thihg pain with ambulation.
  • Painful lumbar ROM
  • Waddels Signs

Lumbar DDD Xray / Diagnositc Tests

  • A/P, lateral, flexion/extensionviews demonstrate disk-space narrowing, end-plate sclerosis, osteophyte formation, facet hypertrophy, spondylosis,
  • Segmetnal Instability = 4.5mm or 15 degrees of sagittal displacement on flexion/extension views.
  • MRI: High-intensity zones (T2-images) represent annular tears. Loss of normal disc signal dark discs, Modic changes in the end plate and vertebral body.
  • Diskography: high-false negatives. Positve result = annular disruption, reproduction of patients symptoms (concordant pain) and negative control levels. Classification of chages = Adams MA, JBJS 1986;68Br36.

Lumbar DDD Classification / Treatment

  • Activity limitations, NSAIDS, Physical therapy (Hayden JA, Ann INtern Med 2005;142:765), muscle relaxants, Narcotics, progressive activity.
  • No Benefit vs placebo: electrical nerve stimulation, topical magnets, traction, IDET (Freeman BJ, Spine 2005;30:2369).
  • Surgical options: ALIF, PLIF, TLIF, Posterior fusion, total disc replacement.

Lumbar DDD Associated Injuries / Differential Diagnosis

  • Cauda Equina Syndrome
  • Herniated disc
  • Lumbar spinal stenosis

Lumbar DDD Complications

Lumbar DDD Follow-up Care

  • 91% acceptable outcome for spinal fusion in patients with segmental instability, 43% for discogenic pain confimed by diskigraphy (Carragee EJ, Spine 2006;31:2115).

Lumbar DDD Review References

  • °

Disclaimer

The information on this website is intended for orthopaedic surgeons.  It is not intended for the general public. The information on this website may not be complete or accurate.  The eORIF website is not an authoritative reference for orthopaedic surgery or medicine and does not represent the "standard of care".  While the information on this site is about health care issues and sports medicine, it is not medical advice. People seeking specific medical advice or assistance should contact a board certified physician.  See Site Terms / Full Disclaimer