Degenerative disc disease is the leading cause of missed work, resulting in more than $20 billion in lost revenue each year.

This disease affects invertebral discs, which provide cushion in between your spine and vertebrae. They are designed to carry your weight and aid your body's range of motion.

When these discs break down, a person often experiences low, chronic back pain. Often, people with this disease get to a point where they can no longer tolerate the pain, or it causes neurological problems.

When most people hear the words "degenerative discs," they immediately think of the aging process. It's true, this disease can develop with age, and genetics can also be a cause. But other factors can speed up this process.

Smoking is one of these factors. Studies have shown that people who smoke are three to four times more likely to develop degenerative disc disease than the average person.

When carbon monoxide enters the bloodstream, it prevents the body from absorbing the nutrients it needs from blood, and it makes discs less pliable. Many surgeons refuse to operate on patients who smoke because smoking impedes new bone growth. This is essential for successful spinal fusion, an operation to correct pain from degenerative discs.

Weight also plays a significant role in patients with degenerative disc disease. Excess weight causes even more pressure and strain on your vertebrae and discs. An obese patient who loses weight before having spinal surgery will have a much greater success rate.

Typically this disease is first treated with physical therapy and pain management, but when those methods don't work, surgery is the next step.

Surgery is also needed when patients experience neurological implications, such as compression on the nerves in the spinal cord, which can result in numbness in the legs or other extremities.

Surgical options typically involve posterior or anterior spinal fusion. Surgeons remove what's compressing the nerve and then fuse the spine to stabilize it and help it regain normal function. A posterior approach is when an incision is made in the back, above the tail bone region. This method is typically used for patients with leg pain. The anterior approach is when you enter through the abdomen. This method is often tolerated better and is similar to a cesarean section, but it is not for everyone.

With any major back surgery, it's essential that all other options, such as pain management and physical therapy, have been tried first. Surgery should be used as a last resort; however, patients shouldn't fear this option. There is a 90 percent success rate with this type of surgery, and many patients experience no restrictions after surgery. It's important to talk to your doctor and identify what options are best for you.

Dr. Daniel Scodary is board certified in neurosurgery and is on staff at the SSM Neurosciences Institute at DePaul Health Center. His offices are located at 12255 DePaul Drive, Suite 830, in the North Medical Office Building. He can be reached at 314-291-6556. For more information visit www.ssmhealth.com/neurosciences