TAILIEUCHUNG - Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 15

Spinal Disorders: Fundamentals of Diagnosis and Treatment Part 15. Spinal disorders are among the most common medical conditions with significant impact on health related quality of life, use of health care resources and socio-economic costs. Spinal surgery is still one of the fastest growing areas in clinical medicine. | Age-Related Changes of the Spine Chapter 4 115 Key Articles Kirkaldy-Willis WH Wedge JH Yong-Hing K Reilly J 1978 Pathology and pathogenesis of lumbar spondylosis and stenosis. Spine 3 4 319-28 In this study autopsy specimens of lumbar spines were used to define the degenerative cascade of the spine. Progressive degenerative changes in the posterior joints lead to destruction and instability. Similar changes in the disc result in herniation internal disruption and resorption. Combined changes in posterior joint and disc can produce entrapment of a spinal nerve in the lateral recess and or central stenosis. Changes at one level often lead over a period of years to multilevel spondylosis and or stenosis. Miller JA Schmatz C Schultz AB 1988 Lumbar disc degeneration correlation with age sex and spine level in 600 autopsy specimens. Spine 13 2 173-8 This meta-analysis is based on data from 16 published reports. Macroscopic disc degeneration grades were correlated with age sex and level in 600 lumbar discs from 273 cadavers 0-96 years of age . Male discs were significantly more degenerated than female discs in the second and fifth to seventh life decades. L4 L5 and L3 L4 level discs showed more degeneration than other levels. Higher mechanical stress perhaps combined with longer nutritional pathways may be responsible for the earlier degeneration of male discs. Boos N Weissbach S Rohrbach H Weiler C Spratt KF Nerlich AG 2002 2002 Volvo Award in Basic Science Classification of age-related changes in lumbar intervertebral discs. Spine 27 23 2631-44 This paper provides a systematic semiquantitative assessment of age-related morphologic changes in the intervertebral disc and cartilaginous endplate which is based on 20250 histologic variables. The study revealed significant temporospatial variations with regard to presence and abundance of histologic disc alterations across levels regions macroscopic degeneration grades and age groups. The detailed analysis resulted in a .

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