The Aging Spine.pdf

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

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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5 4 3 2 1 0

Institute

Centenary Clinic

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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