Degenerative disc disease

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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)

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

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.