Acute Spinal Problems in the Elderly

The human spine has two structural and one main physiological function. The first structural function is to maintain the erect posture to allow a bipedal stance and the second is to protect the neurological elements, namely the spinal cord and the derived nerve roots. Physiologically, the spine is responsible for the majority of haematopoiesis in the skeletally mature adult. Failure of the spine can be observed as a loss of these functions; spinal deformity and neurological deficit. Clinically "spine failure" manifests like many other non-spinal pathologies in the elderly such as reduced mobility, falls and loss of independence. The management of these problems poses a challenge in this population. It is anticipated that, with an ageing population, the incidence of these issues will increase across medical specialties and so awareness of their presentation and treatment is significant. In this review, we aim to provide an overview of the diagnosis and current treatment of the most prevalent spine issues in the elderly including osteoporotic fracture, C2 fractures, myelopathy, Metastatic Spinal Cord Compression (MSCC) and lumbar stenosis.