Ferguson Stephen J, Steffen Thomas
M.E. Müller Research Center for Orthopaedic Surgery, Institute for Surgical Technology and Biomechanics, University of Berne, Murtenstrasse 35, Postbox 8354, 3001, Berne, Switzerland.
Eur Spine J. 2003 Oct;12 Suppl 2(Suppl 2):S97-S103. doi: 10.1007/s00586-003-0621-0. Epub 2003 Sep 9.
The human spine is composed of highly specific tissues and structures, which together provide the extensive range of motion and considerable load carrying capacity required for the physical activities of daily life. Alterations to the form and composition of the individual structures of the spine with increasing age can increase the risk of injury and can have a profound influence on the quality of life. Cancellous bone forms the structural framework of the vertebral body. Individual trabeculae are oriented along the paths of principal forces and play a crucial role in the transfer of the predominantly compressive forces along the spine. Age-related changes to the cancellous core of the vertebra includes a loss of bone mineral density, as well as morphological changes including trabecular thinning, increased intratrabecular spacing, and loss of connectivity between trabeculae. Material and morphological changes may lead to an increased risk of vertebral fracture. The vertebral endplate serves the dual role of containing the adjacent disc and evenly distributing applied loads to the underlying cancellous bone and the cortex of the vertebra. With aging, thinning of the endplate, and loss of bone mineral density increases the risk of endplate fracture. Ossification of the endplate may have consequences for the nutritional supply and hydration of the intervertebral disc. The healthy intervertebral disc provides mobility to the spine and transfers load via hydrostatic pressurization of the hydrated nucleus pulposus. Changes to the tissue properties of the disc, including dehydration and reorganization of the nucleus and stiffening of the annulus fibrosus, markedly alter the mechanics of load transfer in the spine. There is no direct correlation between degenerative changes to the disc and to the adjacent vertebral bodies. Furthermore, advancing age is not the sole factor in the degeneration of the spine. Further study is crucial for understanding the unique biomechanical function of the aging spine.
人类脊柱由高度特定的组织和结构组成，它们共同提供日常生活身体活动所需的广泛运动范围和相当大的承载能力。随着年龄增长，脊柱各个结构的形态和组成发生改变，会增加受伤风险，并对生活质量产生深远影响。松质骨构成椎体的结构框架。单个小梁沿主要力的路径排列，在沿脊柱传递主要压缩力方面起着关键作用。与年龄相关的椎体松质核心变化包括骨矿物质密度降低，以及形态学变化，如小梁变薄、小梁内间距增加和小梁之间连接性丧失。材料和形态学变化可能导致椎体骨折风险增加。椎体终板具有双重作用，即容纳相邻椎间盘并将施加的负荷均匀分布到下方的松质骨和椎体皮质。随着年龄增长，终板变薄和骨矿物质密度降低会增加终板骨折的风险。终板骨化可能会对椎间盘的营养供应和水合作用产生影响。健康的椎间盘为脊柱提供活动度，并通过水合髓核的静水压力传递负荷。椎间盘组织特性的变化，包括髓核脱水和重组以及纤维环变硬，会显著改变脊柱的负荷传递力学。椎间盘退变与相邻椎体退变之间没有直接关联。此外，年龄增长并非脊柱退变的唯一因素。进一步研究对于理解衰老脊柱独特的生物力学功能至关重要。
