Degenerative disc disease

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Degenerative disc disease, abbreviated DDD, is a common ditzel, typically generated in the course of a discectomy operation.

Degenerative disc disease
Diagnosis in short

Degenerative disc disease. HPS stain.

LM benign fibrous tissue, nests of chondrocytes
LM DDx chondrocalcinosis, synovial cyst, malignancy (primary or metastasis)
Site vertebral disc - see spine

Symptoms back pain
Prevalence common
Radiology disc herniation
Prognosis benign
Treatment surgical (e.g. discectomy)

Sciatica,[1] vertebral disc and discectomy redirect here.

General

  • Herniated disc - causes back pain.
  • May result in cauda equina syndrome.
  • Composed of fibrous cartilage.[2]

Microscopic

Features:

  • Benign fibrous tissue.
  • Nests of chondrocytes (as in immature cartilage).
  • +/-Synovium with or without proliferation.[3]
  • +/-Neovascularization of disc material.[3]
  • Hemosiderin deposits (trauma or previous surgery).

DDx:

Images

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Disc Material (L4-L5 Disc), Excision:
- Consistent with disc material (gross only).
Disc Material (Left L5-S1 Disc), Excision:
- Consistent with disc material (gross only).

Note:

  • May be gross only specimens; a minority of institutions handle these specimens this way.[6]
    • It is suggested that gross only specimens should have no history or suspicion of malignancy - based on the surgical note, available pathology and imaging.

Block letters

CERVICAL DISC, DISCECTOMY:
- DISC WITH DEGENERATIVE CHANGES.
- NO EVIDENCE OF MALIGNANCY.
LUMBAR DISC, DECOMPRESSION:
- DEGENERATIVE DISC DISEASE.

See also

References

  1. Suthar, P.; Patel, R.; Mehta, C.; Patel, N. (Apr 2015). "MRI evaluation of lumbar disc degenerative disease.". J Clin Diagn Res 9 (4): TC04-9. doi:10.7860/JCDR/2015/11927.5761. PMID 26023617.
  2. URL: http://www.lab.anhb.uwa.edu.au/mb140/CorePages/Cartilage/Cartil.htm. Accessed on: 2 January 2010.
  3. 3.0 3.1 3.2 3.3 Pytel, P.; Wollmann, RL.; Fessler, RG.; Krausz, TN.; Montag, AG. (Feb 2006). "Degenerative spine disease : pathologic findings in 985 surgical specimens.". Am J Clin Pathol 125 (2): 193-202. doi:10.1309/89FV-RT04-EGBV-EUD9. PMID 16393686.
  4. Hasselblatt, M.; Maintz, D.; Goll, T.; Wildförster, U.; Schul, C.; Paulus, W. (Jan 2006). "Frequency of unexpected and important histopathological findings in routine intervertebral disc surgery.". J Neurosurg Spine 4 (1): 20-3. doi:10.3171/spi.2006.4.1.20. PMID 16506461.
  5. Modic, MT.; Ross, JS. (Oct 2007). "Lumbar degenerative disk disease.". Radiology 245 (1): 43-61. doi:10.1148/radiol.2451051706. PMID 17885180.
  6. Zarbo, RJ.; Nakhleh, RE. (Feb 1999). "Surgical pathology specimens for gross examination only and exempt from submission: a College of American Pathologists Q-Probes study of current policies in 413 institutions.". Arch Pathol Lab Med 123 (2): 133-9. doi:10.1043/0003-9985(1999)1230133:SPSFGE2.0.CO;2. PMID 10050786.