Degenerative Spinal Changes: General Terminology
The general term for these degenerative changes—including disc disease, facet arthritis, and spinal stenosis—is "degenerative disease of the spine" (DDS) or "degenerative spinal disease." 1, 2
Terminology and Scope
The umbrella term encompasses multiple pathological processes that commonly occur together:
- Disc degeneration (degenerative disc disease or intervertebral disc syndrome) 3, 4
- Facet joint arthrosis (facet joint syndrome or zygapophysial joint degeneration) 3, 1, 4
- Spinal stenosis (narrowing of the spinal canal from degenerative changes) 3, 5
- Ligamentum flavum hypertrophy 5
- Osteophyte formation 2
- Degenerative spondylolisthesis 2
Key Clinical Context
These degenerative changes represent metabolic disturbances in the matrix of intervertebral discs and zygapophysial joints, with the strongest correlation being age rather than symptoms. 6 This is a critical distinction because:
- Degenerative changes on imaging frequently occur in asymptomatic individuals and do not constitute a diagnosis by themselves. 7, 6
- Many MRI abnormalities can be seen in people without any back pain. 7
- The presence of degenerative changes lacks significant correlation with spinal pain. 6
Common Clinical Presentations
When symptomatic, DDS manifests as:
- Chronic axial spine pain (facet joint syndrome, sacroiliac joint syndrome, intervertebral disc syndrome) 3
- Chronic radicular spine pain (from disc herniation/bulge, spinal stenosis) 3
- Neurogenic claudication, paresthesia, and lower extremity weakness (from lumbar spinal stenosis) 5
The median baseline pain intensity in clinical trials is 6.8/10 on visual analog scale, with median pain duration of 46 months. 3
Important Caveats
Do not use imaging findings alone to diagnose the source of pain—clinical correlation is essential. 7, 2 The history and physical examination are determinative, not the radiographic findings. 1