The human spine is composed of highly specific tissues and structures, which together provide the extensive range of motion and considerable load carrying capacity required for the physical activities of daily life. Alterations to the form and composition of the individual structures of the spine with increasing age can increase the risk of injury and can have a profound influence on the quality of life. Cancellous bone forms the structural framework of the vertebral body. Individual trabeculae are oriented along the paths of principal forces and play a crucial role in the transfer of the predominantly compressive forces along the spine. Age-related changes to the cancellous core of the vertebra includes a loss of bone mineral density, as well as morphological changes including trabecular thinning, increased intratrabecular spacing, and loss of connectivity between trabeculae. Material and morphological changes may lead to an increased risk of vertebral fracture. The vertebral endplate serves the dual role of containing the adjacent disc and evenly distributing applied loads to the underlying cancellous bone and the cortex of the vertebra. With aging, thinning of the endplate, and loss of bone mineral density increases the risk of endplate fracture. Ossification of the endplate may have consequences for the nutritional supply and hydration of the intervertebral disc. The healthy intervertebral disc provides mobility to the spine and transfers load via hydrostatic pressurization of the hydrated nucleus pulposus. Changes to the tissue properties of the disc, including dehydration and reorganization of the nucleus and stiffening of the annulus fibrosus, markedly alter the mechanics of load transfer in the spine. There is no direct correlation between degenerative changes to the disc and to the adjacent vertebral bodies. Furthermore, advancing age is not the sole factor in the degeneration of the spine. Further study is crucial for understanding the unique biomechanical function of the aging spine.
KeywordsAging spine Biomechanics Osteoporosis Vertebral endplate Disc degeneration
Unable to display preview. Download preview PDF.
- 8.Ferguson SJ, Ito K, Nolte LP (2003) Fluid flow and convective transport of solutes within the intervertebral disc. J Biomech (in press)Google Scholar
- 21.Leidig-Bruckner G, Limberg B, Felsenberg D, Bruckner T, Holder S, Kather A, Miksch J, Wuster C, Ziegler R, Scheidt-Nave C (2000) Sex difference in the validity of vertebral deformities as an index of prevalent vertebral osteoporotic fractures: a population survey of older men and women. Osteoporos Int 11:102–119PubMedGoogle Scholar
- 22.Mazess RB (1982) On aging bone loss. Clin Orthop 239–252Google Scholar
- 24.National Institutes of Health (2003) Osteoporosis prevention, diagnosis and therapy. NIH consensus statement 17:1–36Google Scholar
- 28.Polikeit A (2002) Finite element analyses of the lumbar spine: clinical applications. Ph. D. Thesis, University of BerneGoogle Scholar
- 36.Twomey LT, Taylor JR (1987) Age changes in lumbar vertebrae and intervertebral discs. Clin Orthop 97–104Google Scholar
- 38.Vernon-Roberts B (1988) Disc pathology and disease states. In: Ghosh P (ed) The biology of the intervertebral disc. CRC, Boca Raton, pp 73–120Google Scholar
- 39.Wagner AL, Murtagh FR, Arrington JA, Stallworth D (2000) Relationship of Schmorl’s nodes to vertebral body endplate fractures and acute endplate disk extrusions. AJNR Am J Neuroradiol 21:276–281Google Scholar