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EUROSPINE: Some key facts about the aging spine

Some key facts about the aging spine

While lower back pain is extremely common, the symptoms and severity of lower back pain vary greatly. A simple lower back muscle strain might be excruciating enough to necessitate an emergency room visit, while a degenerating disc might cause only mild, intermittent discomfort.

Younger adults (30 to 60 year olds) are more likely to experience back pain from the disc space itself (e.g. lumbar disc herniation) or from a back muscle strain or other soft tissue strain.

Most patients who suffer from an acute episode of back pain recover without surgery. 3-5% of patients presenting with back pain have a herniated disc, 1-2% have compression of a nerve root. Patients are commonly treated in primary care but a small proportion is referred to secondary care and may eventually undergo surgery if complaints remain present for at least 6 weeks.

Older adults (over 60) are more likely to suffer from pain related to joint degeneration (such as osteoarthritis or lumbar spinal stenosis) or from a vertebral body fracture.

The loss of the sagittal balance and the poor bone quality are major problems in the aging spine:

Sagittal plane alignment is recognized as an important parameter in the development of adult spinal deformity. The loss of lumbar lordosis can be considered as the initiating event of sagittal imbalance. This loss of the normal lordosis pushes the C7 plumb line forward. The imbalance of the spine increases until compensation is no longer possible. Adult spinal deformities and degeneration of the spine are the consequences, e.g. lumbar spinal stenosis.

Lumbar spinal stenosis is the most frequent reason for spinal surgery in elderly people. Patients complain of neurogenic claudication (pain in the buttocks and lower extremities provoked by walking and relieved by rest). It is compatible with a narrowing of the lumbar spinal canal. When appropriately indicated, lumbar spine surgery can provide significant relief to patients who have failed conservative treatment. Another common problem among elderly patients are vertebral body fractures. The most common etiology of vertebral body fractures is osteoporosis.

The prevalence of osteoporosis is 6.6 % in men and 22.1 % in women aged 50 years. Of all countries in the EU27, Germany was estimated to have the highest number of individuals with osteoporosis with approximately 1 million osteoporotic men and 4 million osteoporotic women

25% of postmenopausal women are affected by a compression fracture during their lifetime. Although these fractures rarely require hospital admission, they have the potential to cause significant disability and morbidity, often causing incapacitating back pain for many months. If there is no response to conservative treatment, hospital admission might be necessary. There are several surgical options for the management of painful osteoporotic fractures. Vertebral augmentation through minimally invasive techniques such as kyphoplasty and percutaneous vertebroplasty are among the most popular. Another important point in treating vertebral body fractures is prevention and the treatment of osteoporosis.

Understanding the aging spine, giving treatment guidelines and increasing life quality in patients at all ages will be the challenge for spine specialists and the healthcare system in the next decade.

Press contact, interview requests, accreditation:

Felix Degeler
Public Information Officer
Phone: +41 44 586 4888

Anna Faber
Head of Communications

02 Oct 2016
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