Assessment and management of patients with degenerative spine disease

Degenerative spine conditions can be asymptomatic but may present as back pain, leg pain, or both. Back pain is common, affecting over 80% of the population at some point. Many cases resolve with the passage of time, early rehabilitation and physiotherapy. Leg pain can either be referred, stenotic or radiculopathic in nature. Serious causes should be detected with the use of ‘red flags’ and surgery reserved for only the most severe cases that have not responded to conservative measures. The clinical features, investigations and management of the common degenerative spine pathologies are discussed here.