The Aging Spine

Break­ing Down the Most Com­mon Con­di­tions of the Aging Spine

Essen­tial­ly, there are two fac­tors that can cause issues to the spine as we age. The first is change in the struc­tur­al integri­ty of the bone itself, oth­er­wise known as bone min­er­al den­si­ty. The sec­ond is wear and tear, or degen­er­a­tion, of the var­i­ous motion pro­duc­ing struc­tures of the spine. While there are a vari­ety of spine issues one may expe­ri­ence, these two types of con­di­tions tend to make up the major­i­ty of med­ical issues that bring patients to their doctor.

Bone Health

When we talk about the integri­ty of the bone, we are refer­ring to the bone’s min­er­al den­si­ty. Bone min­er­al den­si­ty deter­mines the over­all struc­ture and strength of our bones, with denser bones indi­cat­ing more strength. As bone los­es den­si­ty, it becomes increas­ing­ly porous, or weak and frag­ile. The more porous the bone, the more sus­cep­ti­ble it becomes to frac­ture. Depend­ing on the mag­ni­tude of den­si­ty loss, a patient may be cat­e­go­rized as hav­ing nor­mal bone den­si­ty (accept­able poros­i­ty of bone), osteope­nia (bone that is weak­er than nor­mal) or osteo­poro­sis (very weak and frag­ile bone that is more eas­i­ly fractured).

Osteope­nia & Osteoporosis

While nor­mal bone den­si­ty lev­els are ide­al for your health and safe­ty, osteope­nia and osteo­poro­sis diag­noses are more com­mon than you may think. In fact, 44 mil­lion Amer­i­cans car­ry the diag­no­sis of osteope­nia or osteo­poro­sis, with two mil­lion Amer­i­cans sus­tain­ing osteo­poro­sis relat­ed frac­tures each year. Near­ly half of these frac­tures occur in the spine, known as ver­te­bral frac­tures. A greater num­ber of women are affect­ed by osteope­nia and osteo­poro­sis dis­pro­por­tion­ate­ly com­pared to men, espe­cial­ly post-menopausal women as young as 50 years of age. 

How This Affects the Spine

The unfor­tu­nate con­se­quence of osteo­poro­sis is that it puts you at risk of low-ener­gy frac­tures, mean­ing some­thing as lit­tle as a ground-lev­el fall, or even a vio­lent sneeze in the most severe cas­es, can cause a bone frac­ture. When osteo­poro­sis relat­ed frac­tures occur, they can cause pain, defor­mi­ty and neu­ro­log­i­cal prob­lems; you may even find that you are not as tall as you were pre­vi­ous­ly or that you have devel­oped a hump in your back. 

Prevention/​Management

Pre­ven­tion goes a long way in keep­ing your bones safe and strong. To main­tain healthy bone den­si­ty, eat a bal­anced diet, exer­cise reg­u­lar­ly, avoid smok­ing and alco­hol and sup­ple­ment your diet with vit­a­min D and cal­ci­um if need­ed. If you have low bone den­si­ty, or believe you are at risk of devel­op­ing osteope­nia or osteo­poro­sis, con­sult your physi­cian to learn more about diag­no­sis and treatment. 

The Degen­er­a­tive Spine

Terms such as degen­er­a­tive disc dis­ease, spondy­lo­sis, arthri­tis, bulging discs and steno­sis all describe find­ings com­mon­ly seen in an aging spine. The aging process of the spine results from mul­ti­ple fac­tors, includ­ing genet­ics, bio­chem­i­cal changes with­in the body, phys­i­cal adap­ta­tions and the mechan­i­cal wear and tear result­ing from sim­ple use. When it comes to the aging spine, genet­ics plays an impor­tant role, as some peo­ple are more vul­ner­a­ble to spine degen­er­a­tion at an ear­li­er age or at a faster rate than oth­ers. Often times, the effects of wear and tear do not war­rant sur­gi­cal inter­ven­tion and treat­ment is not typ­i­cal­ly nec­es­sary until these changes cause pain. 

How This Affects the Spine

Degen­er­a­tion of the discs and/​or indi­vid­ual joints can be poten­tial sources of pain. Because degen­er­a­tion rarely occurs in one spot, it can be dif­fi­cult to pin­point the spe­cif­ic joint or disc that is caus­ing the pain. Addi­tion­al­ly, due to the close prox­im­i­ty of our spinal discs and joints to the spinal cord and the var­i­ous nerves which stem from it, struc­tur­al changes may result in steno­sis, the phys­i­cal nar­row­ing of the space which con­tains neu­ro­log­ic struc­tures. Depend­ing on the pre­cise loca­tion, if this hap­pens, the result­ing com­pres­sion of neu­ro­log­i­cal struc­tures may cause pain, numb­ness, tin­gling, and/​or weak­ness in the arms or legs, bal­ance and dex­ter­i­ty prob­lems and changes in your bow­el and blad­der function.

Prevention/​Management

While we’re cur­rent­ly unable to pre­vent the aging and degen­er­a­tion of the spine, you may be able to avoid symp­toms by main­tain­ing a healthy and active lifestyle, nor­mal­iz­ing your Body Mass Index (BMI), devel­op­ing a strong core, prac­tic­ing good pos­ture, avoid­ing tobac­co and alco­hol use and uti­liz­ing safe lift­ing mechanics.

If you do devel­op symp­toms, there are a vari­ety of treat­ment options to con­sid­er. In the major­i­ty of cas­es, treat­ment is non-sur­gi­cal and high­ly effec­tive. How­ev­er, in the few cas­es that do require sur­gi­cal inter­ven­tion, sophis­ti­cat­ed tech­niques, includ­ing min­i­mal­ly inva­sive surgery, are avail­able to suc­cess­ful­ly treat your condition.

The bot­tom line is you were giv­en one spine and it has to last your life­time. While there are cer­tain things you can con­trol, such as mak­ing healthy lifestyle changes, there are oth­ers you can­not. Stack the cards in your favor by bet­ter under­stand­ing the way your spine works and tak­ing the nec­es­sary steps to help your spine age gracefully. 

If you do expe­ri­ence spine prob­lems, the Duly Health and Care Spine Sur­geons have your back, offer­ing lead­ing-edge treat­ment tech­niques and qual­i­ty spine care to address all of your needs. Click here for more infor­ma­tion on spine health and con­di­tions, or to sched­ule an appoint­ment with one of our specialists.

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  • Michael Conti Mica, MD, Elmhurst Spine Surgeon

    I strive to provide the right treatment options for each individual patient. Developing personalized care centered around each patient's goals, aligned with outcome-driven, evidence-based medicine is fundamental to my philosophy. My goal is to reduce your pain and improve your function so that you may focus on living your life rather than managing your condition. Fortunately, most neck and back related problems can be resolved with non-surgical care. Our integrated team will guide your treatment and efficiently coordinate your care. If surgery is necessary, I am trained in both cutting-edge open and minimally invasive techniques for the treatment of various spine conditions. I specialize in the treatment of degenerative and traumatic spine conditions with particular interest in minimally invasive, motion preserving, and robotic-assisted spine surgery. Whether your goal is to return to professional sport or lifting your grandchild, I will treat you with compassionate diligence.