The Importance of Disc Height Preservation – Keep Your Tall Spine!

Blog 1 of “The Tall Spine” gives insight into the intervertebral discs, the very cushions that keep your spine tall! These remarkable cartilaginous structures cushion and stabilize the spine from head to sacrum.

The spine is made up of 7 cervical vertebrae, 12 thoracic vertebrae, and 5 lumbar vertebrae. These 24 spinal vertebrae are stacked on top of each other with an intervertebral disc—23 in total—positioned between each level. This arrangement configures your spine, so your head is positioned at the top with your pelvis at the bottom, creating a harmonious symphony of sagittal balance. This balance keeps humans upright and bipedal, allowing us to walk with our eyes forward in horizontal gaze. Lose that balance, and you start bending forward, making it more difficult to stay upright and look ahead. This condition is called kyphosis, and if it progresses, you may first need a cane, then a walker, and possibly even a wheelchair.

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You may know you are at risk of developing kyphosis if you consistently need to lean forward against something, like a counter or a grocery cart, when standing or walking. I often thought the seat plate of a grocery cart would be a good place to advertise: “If you are reading this, then you have kyphosis and spinal stenosis, so call me,” much like Zappos has their ads positioned at the bottom of the TSA bin used for screening at commercial airports.

The intervertebral discs are made up of cartilage, and like any cartilaginous structure, they are generally susceptible to degeneration naturally and slowly with age. If the degeneration is too progressive—i.e., degenerative disc disease (DDD)—the disc space will lose height, narrow, and put unfavorable pressure on the spinal cord traveling through the spinal canal, or the nerve roots exiting the foramen at each level, by way of the disc circumferentially bulging and forming bone spurs with height collapse.

The best way to manage the natural progression of DDD is to avoid it by watching your weight, eating a healthy diet, stretching, and exercising regularly. Standing, walking, and moving around versus sitting helps too. There are many spine-specific exercises you could do daily that will keep you feeling good and upright.

DDD may also occur at specific disc(s) due to injury. This more abrupt issue is not natural, and your body will respond in ways to protect the injured disc. You may experience muscle spasms and have restricted movements, and you might even be temporarily bedridden due to pain. All of this is often a warning sign that a disc has been injured.

It is becoming clear that early intervention for an injured disc is key to preventing full-blown DDD. At a minimum, you should adhere to good habits like watching your weight, eating a healthy diet, stretching, and exercising regularly. You may need to add massage therapy, chiropractic care, physical therapy, or take some time off to get back on your feet.

If you don’t return to normal quickly, or if these occurrences happen regularly, get an MRI to evaluate what exactly is injured. Knowledge gained from the MRI will better direct therapies and treatments.

There are now regenerative injections available to treat a disc injury in the early stages, helping to eliminate pain and deter the progression of DDD. The type of regenerative injection—stem cell, PRP, adipose-derived stem cells, or others—depends on the degree of disc degeneration at the time of treatment. Surgical options also vary with the degree of DDD, so it is in your best interest to act early with a less invasive approach.

A tall spine is a healthy spine.

Until next time,

Jeffrey J. Larson, MD
Neurosurgeon