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Vertebral Column: Regions and Curvature01:16

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The vertebral column or spine is a flexible column that supports the head, neck, and body and  allows for their movements. It also protects the spinal cord.
Regions of the Vertebral Column
In an adult, the spine is subdivided into five regions: the cervical, the thoracic, the lumbar, the sacral, and the coccygeal region. The spine initially develops as a series of 33 vertebrae; after 20 years of age, the nine bones in the sacral region, five sacral, and four coccygeal bones fuse to form...
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Treating the Aging Spine.

Theodore J Choma1, Glenn Rechtine, Robert A McGuire

  • 1Professor and Vice Chairman, Department of Orthopaedic Surgery, University of Missouri, Columbia, Missouri.

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Summary
This summary is machine-generated.

Caring for older patients with spine conditions requires recognizing unique challenges like osteoporosis and degenerative deformities. Treatment involves optimizing bone health and surgical techniques for better spinal fixation and deformity correction.

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Area of Science:

  • Orthopaedic Surgery
  • Geriatric Medicine
  • Spine Pathology

Background:

  • Demographic shifts necessitate specialized care for elderly patients with spinal conditions.
  • Older adults present unique pathologies including osteoporosis and degenerative deformities.
  • Effective management requires addressing age-related bone health and biomechanical changes.

Purpose of the Study:

  • To outline the challenges and current management strategies for spine pathology in geriatric patients.
  • To review medical and surgical options for optimizing bone health and spinal fixation in the elderly.
  • To discuss approaches to degenerative spinal deformities, emphasizing sagittal balance.

Main Methods:

  • Review of current literature on geriatric spine care, osteoporosis management, and degenerative deformity treatment.
  • Analysis of treatment options including medical optimization (e.g., vitamin D, bisphosphonates, teriparatide) and surgical techniques.
  • Consideration of specific conditions like odontoid fractures and degenerative deformities in the elderly.

Main Results:

  • Medical optimization of bone health is crucial, with options like vitamin D, calcium, diphosphonates, and teriparatide.
  • Cement augmentation of pedicle screws shows promise for improving spinal fixation in osteoporotic elderly patients.
  • Management of geriatric odontoid fractures varies by patient demand (conservative vs. surgical).
  • Degenerative deformity management requires attention to sagittal plane balance and may involve osteotomies.

Conclusions:

  • Orthopaedic spine surgeons must adapt their approach to the unique needs of older patients.
  • Optimizing bone health and employing advanced surgical techniques are key to successful outcomes in geriatric spinal care.
  • Tailored management strategies are essential for conditions ranging from fractures to degenerative deformities in the elderly.