From local to systemic: spinal aging in the multi-organ aging network.

Area of Science:

• Gerontology
• Orthopedics
• Regenerative Medicine

Background:

• Spinal aging is a complex process leading to degenerative spinal diseases (DSDs).
• Previous research focused on local spinal tissues, neglecting systemic aging influences.
• Geroscience reveals spinal degeneration is linked to a multi-organ aging network.

Purpose of the Study:

• To propose a "from local to systemic" framework for understanding spinal aging mechanisms.
• To integrate vertebral osteoporosis and paraspinal muscle degeneration into spinal aging.
• To highlight systemic factors influencing DSDs and their treatment.

Main Methods:

• Review of current literature on spinal aging and geroscience.
• Analysis of local and systemic factors contributing to spinal degeneration.
• Discussion of clinical translation and therapeutic strategies for DSDs.

Main Results:

• Spinal aging involves heterogeneous local trajectories, with intervertebral disc degeneration (IVDD) as a central process.
• Systemic aging (immunosenescence, muscle aging, etc.) impacts the spine via circulating factors and metabolic mediators.
• DSDs are influenced by systemic aging, affecting disease progression and treatment response.

Conclusions:

• The spine should be viewed as an integrated organ system within systemic aging.
• Future DSD treatments require precise stratification and systemic anti-aging strategies.
• Optimizing long-term outcomes necessitates a holistic approach beyond local interventions.