Info pasal penyakit aku

Antara salah satu diagnos doktor tentang penyakit yang aku alami ialah "Degenerative Disc Disease” atau DD.

Sumber dari Chiropractic Specialty Center Sdn Bhd

Our journey through life leads to degenerative (deterioration) changes in our bodies. The intervertebral discs are included in these changes. Some of these changes are the result of genetic predispositions, excessive load bearing, poor posture, injury and normal changes seen with advancing of age. These changes can range in severity and may include alterations in a disc's architecture, appearance, fluid levels, nutrient levels and behaviour. The medical term, for this type of change in a spinal disc is termed "Degenerative Disc Disease” or DDD. 

Degenerative disc disease (also known as disc degeneration) is not really a disease, but a term used to describe physical alterations within a disc. Although often seen in the elderly, they can be present in young otherwise healthy individuals. Furthermore, significant individual differences can be observed in the sense that young individuals may exhibit the disc of an elderly person and vice versa. So, contrary to the common belief, degenerative disc disease is not an old persons disease. 

Spinal discs degenerate at an alarming rate, far earlier than do other musculoskeletal tissue. A Volvo Award winning research in basic sciences revealed that the first unequivocal finding of degeneration in the lumbar discs are seen at age group 11-16 years. About 20% of people in their teens have discs with mild signs of degeneration; degeneration increases steeply with age, particularly in males, so that around 10% of 50-year-old discs and 60% of 70-year-old discs are SEVERELY DEGENERATED! 

 

A study published in the British Journal of Sports Medicine based on Olympic athletes who presented to the Olympic Polyclinic in the Sydney 2000 games with low back pain and/or sciatica were examined using magnetic resonance imaging (MRI). The results of this study revealed disc related conditions in 58% of those athletes examined, and that degenerative disc disease was the most significant finding. 

Two different studies--one an award winning research in clinical sciences published in the Spine Journal--suggested that disc degenerations are an inherited condition. In fact, they suggested heritability exceeding 60%. 

According to orthopaedic surgeons Jill Urban and Sally Roberts in a review of literature, published in the Arthritis Research & therapy, intervertebral discs show degenerative and aging changes earlier than does any other connective tissue in the body. They reiterated its clinical importance and association with back pain. Another article published in the Spine Journal in February 15, 2000, reported that Disc degeneration of the lumbar spine is considered as one of the underlying factors of low back pain. 

For a better understanding of degenerative disc disease, we need to take a closer look at the spinal disc, its' various parts and how these parts work. The human spinal discs can be described as soft yet tough pads that separate the bones of the spine (vertebrae) from one another. 

These highly specialized structures act as a ligament by holding the vertebrae of the spine together, a shock absorber, and as a pivotal point allowing motion. The adult intervertebral discs are considered the largest avascular (no direct blood supply) structures in the human body, consisting of three main components:

• The Vertebral End-Plates
• The Annulus Fibrosus
• The Nucleus Pulposus

Both the top and the bottom of each vertebra are capped with a thin (approx. ? millimetre) cartilaginous pad called the vertebral end-plate. The vertebral endplate is found at every segment of the spine with exception for the first segment located in the neck just below the skull. Despite their name, these end-plates are not part of the bony vertebrae but strongly interwoven into the disc. 

The end-plates serves as a means of attachment to the bony vertebrae and as a platform from which the avascular discs obtain the life sustaining nutrients. The vertebral end-pates are biochemically similar to the spinal disc. In fact, the water, proteoglycans (specialized protein chains), collagen (a cartilage like substance) and cartilage content of the end-pates mirror that of a spinal disc. This similarity in biochemical makeup helps the diffusion of nutrients into the hungry avascular disc cells. 

The Annulus Fibrosus is the outer layer of the disc and is made of tough fibres for support. It has a higher collagen content and lower water content (60% water) when compared to the nucleus. Its' function is to contain the pressurized nucleus in the center and to firmly attach the disc to the vertebral end-plate and the ring apophysis (bony surface at the periphery of a vertebra). It is made of 15-25 concentric sheets of collagen called the Lamella. The Lamellas are arranged in a special configuration to give them the strength needed for support and to contain the highly pressurized Nucleus Pulposus. 

The Nucleus Pulposa is the inner layer of the disc resembling a soft, jelly-like substance. It has high water content, which enables it to sustain the downward pressure while standing and sitting. It's function is to bear and carry the weight of the body and act as a "pivot-point” which allows for movements. This is the water rich (80%), gelatinous, soft, pulpy, highly elastic, and highly pressurized central structure of the disc. The nucleus is proportionally larger in the cervical (neck) and lumbar (lower back) due to their greater degree of mobility. 

The gentle stretching and relaxing of a non-degenerated, healthy spine fosters diffusion through a phenomenon called "imbibition”. Imagine a sponge filled with water. When the sponge is compressed, the water is forced out. When the compressive force is removed, the water is "sucked” back into the sponge. This is imbibition and it is precisely how the nucleus pulposus stay healthy and functional. 

In the simplest terms, this is one method through which a normal healthy disc gets the vital nutrients needed. The other is diffusion enhanced by a phenomenon called "Diurnal Change”. Our bodies have the ability to expand and compress over the course of a day. During the recumbency of sleep, the loading on the intervertebral disc is reduced, and they are relatively unopposed to swelling pressure. This results in the disc absorbing fluids and increasing in volume. 

In fact a non-degenerated healthy disc will expand some 20%, which in turn increases our stature by 19mm. A 19mm change in stature corresponds to change of about 1.5mm in the height of each lumbar disc. This is why our height is actually measurably increased in the morning. 

The nucleus is made of a protein called proteoglycan that attracts water. Normally, discs compress when pressure is put on them and decompress when pressure is relieved. When a disc is compressed, its water content decreases; when the compressive force is taken away, the water levels are normalized. This happens in healthy discs. This change in the water levels of disc is the sole responsibility of the nucleus through a process called imbibition. 

As mentioned earlier, discs are avascular. Imbibition is the method in which the nucleus acquires the life-sustaining nutrients from the end-plate. Without such transfer, the discs in their entirety will degenerate and eventually will cease to function.