Degenerative changes cause compression of the spinal cord Degenerative disc disease (DDD) may trigger the pathogenesis of<unk> . When intervertebral discs degenerate and change shape in , the normal movements of the spine are interrupted. This results in spinal instability and more degenerative changes in spinal structures including facet joints, ligamentum flavum, and intervertebral discs. These pathologic changes result in narrowing of the vertebral canal and neurovascular compression at the lumbosacral nerve roots. The compression of these spinal nerve roots that control sensation and movement in the lower body results in the tingling, pain and weakness patients often experience. However, because the severity of symptoms does not correlate well with the degree of stenosis and nerve root compression, a clear understanding of the specific pathogenesis remains challenging. It is currently unknown which exact cellular mechanisms within the body causes the pain of as a response to the compression of spinal nerves. The two main proposed mechanisms agree that neurovascular compression plays a role. The ischemic theory proposes that poor blood supply to the spinal nerve roots results in . In contrast, the venous stasis theory proposes that a combination of low oxygen levels and metabolite buildup are responsible due to venous backup at the cauda equina. Pain with walking may be partially explained by the corresponding increase in nerve root oxygen requirements. These changes in blood flow may occur during back extension when shifts in vertebral structures and ligaments narrow the spinal canal and compress the neurovasculature. Compared to a neutral position, extended spines exhibit 15% less cross-sectional area of the intervertebral foramina, and nerve root compression is present one-third of the time. These dynamic changes in the shape of the spinal canal are more pronounced in individuals with spinal stenosis. The amount of narrowing may be 67% in compared to 9% in healthy spines.
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Chronic venous insufficiency