By James J. Yue MD, Richard Guyer, J. Patrick Johnson, Larry T. Khoo, Stephen H. Hochschuler MD
The excellent therapy of the getting older backbone offers all of the state of the art insurance you wish on either operative and non-operative remedies for various medical pathologies of the getting older backbone. Dr James Yue and a crew of gifted, pioneering orthopedic surgeons and neurosurgeons hide sizzling subject matters like minimally invasive fusion, dynamic stabilization, state of the art intraspinous and biologic units, and more.in print and on-line. seek the total textual content and entry a video library on-line at expertconsult.com. grasp the very most modern innovations and applied sciences via specific step by step surgical directions, assistance, and pearls. remain present at the cutting-edge in intraspinous and biologic devices-such as Stent (Alphatec) and Optimesh Spineology; thoracic techniques-kyphoplasty, vertebroplasty, and spacers; and conservative remedy modalities-including injection treatments, acupuncture, and yoga. Make expert-guided judgements on recommendations and equipment choice utilizing the collective medical adventure of pioneering editors and individuals. establish the benefits and drawbacks for the entire diversity of accessible microsurgical and endoscopic strategies for administration of cervical, thoracic, and lumbar backbone pathology-minimally invasive fusion, reconstruction, decompression, and dynamic stabilization. View a narrated video library demonstrating surgical concepts and machine counsel and pearls at the incorporated DVD. View step by step ideas and methods from pioneers within the box
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Additional resources for The Comprehensive Treatment of the Aging Spine: Minimally Invasive and Advanced Techniques (Expert Consult - Online and Print)
Unfortunately, the changes seen in the normal aging spine are very similar to the changes seen in the pathologic and symptomatic spine. Hence, it becomes extremely difficult to differentiate the symptomatic conditions from the manifestations of a normal aging spine. It is only after understanding the normal changes associated with aging that we may be able to identify some of the pathologic changes. The natural history of degenerative disc disease has been studied for many years. 2 Sixty-six percent of the patients who presented with early symptoms did not progress, and approximately 66% of patients with moderate to severe symptoms did not progress either.
INTRODUCTION Back pain is one of the most common reasons for office visits to a physician. 1 Back pain is a condition that predominantly affects the older population. Increased survival rates, better health care outcomes, and improved economic status will increase the number of older people in our society. At present, persons older than 65 years constitute 13% of our population. 2 It is of paramount importance to recognize this trend of aging in the population and plan how best to fulfill the health needs of this growing part of our society.
The gelatinous nature of the disc degenerates into a more fibrotic state due to loss of water content. It is important to understand that a normal disc is composed of 80% water and 20% collagen and proteoglycans. The negatively charged glycosaminoglycans are what allows the nucleus to retain its water content and osmotic pressure. The actual cascade of nucleus degeneration occurs in the following order. First, there is loss of distinction between the nuclear and annular fibers and an increase in the collagen content of the disc, followed by the loss of the negative charges mentioned earlier and loss of water content, greatly reducing the proteoglycan aggregates.