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Degenerative Disc Disease and Spinal Stenosis Found in Young Patients

Surgeons from the Leatherman Spine Center in Louisville, Kentucky report on 76 cases ofjuvenile degenerative disc disease (JDD) in young patients. Out of a possible 1,877 patients referred to their spine center, there were 76 who qualified for this study.

All 76 patients had back pain that lasted more than six months despite treatment. They ranged in age from 11 years to 21 years old. MRIs were taken and reviewed. Anyone with scoliosis, tumors, fracture, or other serious cause of back pain were not included.

Based on MRI results, the diagnosis of JDD was confirmed. The levels most commonly involved were L4-5 and L5-S1. The degenerative discs were usually only at one or two levels, not the entire spine.

A smaller group of 13 patients had both JDD and spinal stenosis. Spinal stenosis is a narrowing of the canal where the spinal cord is located or a narrowing of the opening where the spinal nerves exit. These two conditions are most often seen in older adults as a result of the aging process.

This study showed that low back pain in young adults can be caused by either (or both) of these conditions. In the past, chronic low back pain in this age group was assumed to be either a serious condition like tumor or fracture or psychologic. MRI results showed that some of the young people had congenital spinal stenosis. This means they were born with the condition.

Everyone was advised to avoid activities that involve heavy lifting or repeated bending. A treatment program of antiinflammatory drugs, bracing, and weight loss was started. Everyone also saw a physical therapist for a program of back and abdominal muscle strengthening exercises.

Sports activities were not approved until the patients were improved enough to participate safely. Some patients with both JDD and stenosis didn't get better. They had three epidural injections (once a week for three weeks). Those who still didn't get better had surgery to take pressure off the nerve tissue.

References: John R. Dimar II, MD, et al. Juvenile Degenerative Disc Disease: A Report of 76 Cases Identified by Magnetic Resonance Imaging. In The Spine Journal. May/June 2007. Vol. 7. No. 3. Pp. 332-337.

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