The most common spinal problems occur in the lower back.
Lower Back Problems (lumbar):
Degenerative Disc Disease refers to the gradual deterioration of the disc between the vertebrae. As we age, the water and protein content of the body's cartilage changes. This change results in weaker, thinner and more fragile cartilage. Because both the discs and the joints that stack the vertebrae (facet joints) are partially composed of cartilage, these areas are subject to wear and tear over time (degenerative changes).
Spondylolisthesis is the slippage of one vertebrae upon another. There are multiple "types" of slippage. The degenerative type is commonly seen in the elderlyand the "isthmic" type is commonly seen in the younger population. In the degenerative "older" type, the patient usually has symptoms of spinal stenosis with increased chance of back pain. If the slippage is unstable, back pain becomes more significant. The isthmic (younger) type of slippage is likely present from early adulthood; patients tend to become symptomatic in their 20s or 30s.
Spinal Stenosis is a common problem noted in the elderly population. Stenosis is a fancy term for a narrowing of the spinal canal. As we age, the joints in the spine become arthritic and form bone spurs; the ligaments "thicken" and the discs collapse and "protrude" into the spinal canal. The spinal canal has limited space, and as the bony spurs, discs and ligaments invade the canal, the nerves have less room. The increasing pressure on the nerves causes back and mostly leg pain which usually worsens with standing or walking; the leg pain is usually relieved by sitting or lying down.
