The Spine

1
The Spine
2
Age Related Changes of the Spine, Structures
Involved

• Bone density
• Intervertebral Discs
• Spine ligaments
• Vertebrae
• Ribs Articular cartilage
• Entheses
• Muscles

3
Intervertebral Disc

• Changes occur in the collagen,which increases in
  density.
• Elastin becomes less distensible
• Decreased water content nucleus pulposus,
  gelatinous nucleus becomes a firm and fibrous
  plate

4
Ligaments of the spine

• Tensile strength decreases
• Decreased ability to provide shock absorption
• Lig. Flavum, loses its resting tension therefore
  the spine loses some stability
• Lax ligaments favor a forward flexed posture

5
Vertebrae

• Decreases in strength are seen after age 40
• Loss of 25 bone tissue causes gt 50 vertebral
  strength loss
• Shorter vertebra which is wider at the waist
  (middle)

6
Ribcage

• Needed to assist in maintaining upright position.
  No actual research

7
Articular cartilage

• Decreases in tensile stiffness, fatigue
  resistance, and strength.
• Increased possibility that the articular
  cartilage could sustain microfractures or damage
  from overuse, obesity, trauma,metabolic disease,
  or hereditary factors.
• Thinning and softening of the art. cartilage
  which is subjected to compressive forces results
  in thickening of the joint capsule and the
  development of osteophytes.

8
Enthesis

• Def metallic or other inorganic substances used
  as a substitute to replace lost tissue
• Age related changes also occur here
• Activities causing a tear, rupture, sprain,
  strain of a tendon will affect tissue.
• Collagen is less elastic and distensible when
  engaged in activity

9
Muscular tissue

• Previously discussed

10
ROM

• Greatest loss is in Cervical Extension
• Lumbar spine also loses extension the most.
• Loss of spinal range may have an effect on
  function.
• Wellness programs should address spinal mobility

11
Pathologic Changes

• Arthritis and the Cervical Spine
• Spondylosis this dx. Is only made in the
  presence of sx. Most common C5-6.
• SB and rotation most affected
• May see radiculopathy, check Vertebral artery

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Pathology Cont

• Lumbar Spinal Stenosis. Most common sites are
  the central canal causing cauda equina sx, and
  lat recess causing nerve root compression
• L4-5
• Stabilize pt in as much ext as possible

13
Case Studies

• Pt 1. Cervical spondlylosis with radiating
  pain down R arm.
• Pt 2. Lumbar stenosis
• Pt. 3. Vertebral compression fx. T8-T9,
  secondary dx. Spinal Stenosis