Treatment options and pathophysiology of degenerative spine disease

Abstract Back pain is a common presentation affecting adults of all ages. Making a diagnosis can be challenging as there is poor correlation between patients’ symptoms and the severity of pathology or lack of pathology observed on radiological imaging. This article is an overview of the pathological processes that lead to degenerative spine disease. It is important to understand the normal anatomical variations between the different regions in the spine. Only then can we understand how the same pathological processes can manifest with different symptoms. We describe and suggest treatment options for a spectrum of clinical scenarios including radicular nerve pain, cauda equina syndrome, neurogenic claudication and myelopathy. Structural changes in the form of degenerative scoliosis and spondylolisthesis are also explained. The importance of recognizing red flag characteristics and the management thereof are also detailed.