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Eur Spine J (2001) 10 : S85
DOI 10.1007/s005860100320
Aebi et al. (Eds.)
The Aging Spine
III
M. Aebi · R. Gunzburg · M. Szpalski
(Editors)
The Aging Spine
With 53 Figures and 40 Tables
IV
Prof. Dr. Max Aebi
Dr. Robert Gunzburg
for Evaluative Research
Harmoniestraat 68
in Orthopaedic Surgery
2018 Antwerp
University of Bern
Belgium
Stauffacherstr. 78
3014 Bern
Switzerland
Prof. Dr. Marek Szpalski
Iris South
Teaching Hospitals
142 Rue Marconi
1190 Brussels
Belgium
ISBN 3-540-24408-5 Springer Berlin Heidelberg NewYork
Also published as Volume 12, Supplement 2, October 2003
of the European Spine Journal
ISSN 0940-6719
Library of Congress Control Number: 2005920460
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© Springer-Verlag Berlin Heidelberg 2005
Printed in Germany
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not imply, even in the absence of a specific statement, that such names are exempt from the relevant
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medications contained in this book. In every individual case the user must check such information
by consulting the relevant literature.
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Printing and bookbinding: Mercedes-Druck, Berlin
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5 4 3 2 1 0
Institute
Centenary Clinic
V
Dieter Grob
Foreword
)
Spine Unit, Schulthess Clinic,
Lengghalde 2, 8008 Zurich, Switzerland
Tel.: +41-1-3857436,
Fax: +41-1-3857576,
e-mail: Grob@schulthess-clinic.ch
✉
It is the merit of the “Bone and Joint
Decade” to draw our attention with
increased intensity to the problem of
the changes related to aging of our
musculoskeletal system and the asso-
ciated socioeconomic implications.
In view of the increasing age of the
worldwide population the impact
seems to be tremendous. I congratu-
late the editors of the present supple-
ment of the
European Spine Journal
in picking up this interesting topic
and engaging opinion leaders to con-
tribute their knowledge in this sup-
plement. The various contributions
cover some of the important prob-
lems, which are included in the vast
specter of aging spine: osteoporosis,
spinal stenosis, and tumors of the
spine.
As an introduction Benoist pre-
sents an overview of the important
issue of the natural history of the ag-
ing spine, pointing out that this pro-
cess is a progressive change ending
up in a collapse of the system, a fact
that has implications for treatment
strategy and disease management.
Some of the authors (Bono et al.,
Gunzburg et al., Ferguson et al.) em-
phasize with their contributions the
basic changes and problems that de-
velop during a lifetime in our spine.
These statements illustrate the com-
plexity of the construction and the
variety of responses that the spine is
able to provide.
The medical treatment of the ag-
ing spine deserves special attention
in view of the generally reduced
health situation of the involved pa-
tients. The important role of the
biphosphonates in the treatment, and
perhaps even more so in the preven-
tion, of osteoporosis is emphasized
by Fleisch.
Any successful surgical treatment
starts with accurate diagnostic proce-
dures. The profound knowledge and
sophisticated diagnostic techniques
of the complex pathoanatomical
changes in the spine including the
involvement of the neural structures
(contribution by Dvorak) often go
beyond the capacity of a spine sur-
geon. Teamwork and adequate com-
munication is mandatory.
The variety of different surgical
approaches and options demonstrates
the difficulty of the surgery in the
aging spine. Reduced general health
status, life expectancy with or with-
out cancer that occurs more frequent-
ly in elderly persons, and expecta-
tions of the patient and social envi-
ronment are nonsurgical factors to
be considered before embarking up-
on surgery. The extent of interven-
tion and the clinical significance of
chronic deformities are questions to
be answered at the stage of planning
surgery, and finally fragile soft tis-
sue, osteoporosis, and reduced stabil-
ity are problems to overcome during
surgery.
Although the important question
of economy is addressed in the con-
tribution by Johnell, we are all aware
D. Grob (
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