Degenerative Disc Disease: What is in a Name?. Issue 21 (1st November 2019)

• Record Type: Journal Article
• Authors: Battié, Michele C.; Joshi, Anand B.; Gibbons, Laura E.
• Is Part Of: Spine. Volume 44:Issue 21(2019)
• Publication Date: 2019-11-01
• Subjects: cervical region -- definition -- degenerative disc disease -- disc degeneration -- intervertebral disc -- low back pain -- lumbar region -- nomenclature -- phenotype -- radiculopathy; Spine -- Abnormalities -- Periodicals; Spine -- Diseases -- Periodicals; Spine -- Surgery -- Periodicals; 616.73005
• DOI: 10.1097/BRS.0000000000003103
• Languages: English
• ISSNs: 0362-2436

Abstract

Abstract : Study Design: A systematic search and review Objective: The aim of this study was to investigate the term, degenerative disc disease, to elucidate its current usage and inform clinical, research, and policy recommendations. Summary of Background Data: Degenerative disc disease has long been a dominant concept in common, painful spinal disorders. Yet, despite its pervasiveness and important clinical consequences and controversies, there has not been a systematic examination of its use and meaning in the scientific literature. Methods: We conducted a systematic search of publications using the term degenerative disc disease from 2007 through 2016 in Ovid MEDLINE (R), Embase, CINAHL, and Scopus. Two investigators independently reviewed all publications in the primary sample. Publication and author identifiers, and qualitative study descriptors were extracted. Finally, the definition of degenerative disc disease was placed in one of eight categories. Data were summarized using descriptive statistics. Results: Degenerative disc disease appeared in the titles of 402 publications in the primary sample and increased in frequency by 189% from the first to the last 3 years of the decade. No single definition was used in the majority of publications, and most frequently, the term was used without any definition provided (30.1%). In other cases, degenerative disc disease specifically included radiculopathy or myelopathy (14.4%), or only back or neck pain (5.5%), or was equated with disc degeneration regardless of the presence of symptoms (15.4%), or with discogenic pain or disc degeneration as a presumed cause of axial pain (12.7%). Another 7.2% comprised a mix of broad ranging findings and diagnoses. The most notable differences in definitions occurred between surgeons and other disciplines, and when applied to cervical versus lumbar regions. Conclusion: Despite longstanding use and important consequences, degenerative disc disease represents an underdeveloped concept, with greatly varying, disparate definitions documented. Such inconsistencies challenge clear, accurate communication in medicine and science, create confusion and misconceptions among clinicians, patients and others, and hinder the advancement of related knowledge. Level of Evidence: 4 Abstract : A systematic search and review of use of the term degenerative disc disease in the health sciences literature from 2007 to 2017 was conducted. Although the term was used with increasing frequency, it represents an underdeveloped concept, with greatly varying, disparate definitions documented, leading to confusion and miscommunication in medicine and science.