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Morphologic and Functional Evolution of the Aging Spine

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Spinal Anatomy

Abstract

The process of senescence of the spine begins in the first decade of life and then accelerates from the third. It is essentially fundamentally linked to a phenomenon of entropy that inexorably alters the machinery of all the cells of the body, to which are added random pathologies. Senescence is thus responsible for the so-called degenerative multisystem alterations so that the term “degenerative disc disease” (DDD) is too restrictive and inappropriate. All the connective structures of the column are involved (intervertebral discs, articular joints, and vertebral bone) and also muscle, vascular, and neural components. In addition, there are neurological abnormalities in the cerebral cortex and cerebellum which regulate the functioning of the vertebral column.

The sum of the functional and tissue alterations modifies mechanical behavior both in the vertebrae (osteoporosis often complicated by fractures and deformities) than that of the intervertebral mobile segments, responsible for disc rupture, spondylolisthesis, or degenerative deformities sometimes complicated by radicular or myelopathic abnormalities depending on the levels concerned. The impact of degenerative lesions in the spine is, however, highly variable from one subject to another depending on genetics, lifestyle, and for low back pain, the psychosocial context. The treatment of severe pathologies of the spine in elderly subjects ideally requires the intervention of a case manager who is responsible for proposing to the patient and the family a course of care promoting a comprehensive approach.

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Authors and Affiliations

  1. Spinal Unit, University Hospital, Bordeaux, France

    J. Sénégas, H. Bouloussa & Jean Marc Vital

  2. Neurosurgical Department A, University Hospital of Pellegrin, Bordeaux, France

    D. Liguoro

  3. Department of Orthopedic Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan

    G. Yoshida

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  1. J. Sénégas
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  2. H. Bouloussa
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  3. D. Liguoro
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  4. G. Yoshida
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  5. Jean Marc Vital
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  1. Spinal Unit, Centre Hospitalier, Universitaire de Bordeaux, Bordeaux, France

    Jean Marc Vital

  2. Spinal Unit, Centre Hospitalier, Universitaire de Bordeaux, Bordeaux, France

    Derek Thomas Cawley

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Sénégas, J., Bouloussa, H., Liguoro, D., Yoshida, G., Vital, J.M. (2020). Morphologic and Functional Evolution of the Aging Spine. In: Vital, J., Cawley, D. (eds) Spinal Anatomy . Springer, Cham. https://doi.org/10.1007/978-3-030-20925-4_5

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