[Physiological aging spine].

Physiological aging spine. The process of physiological aging or senescence of the spine begins in the first decade of life and then accelerates from the third. It is essentially fundamentally linked to a phenomenon of entropy that inexorably alters the machinery of all the cells of the body, to which are added random pathologies. Senescence is thus responsible for so-called degenerative multisystem alterations so that the term «degenerative disc disease», is too restrictive and inappropriate. All the connective structures of the column are involved (intervertebral discs, articular joints and vertebral bone) but also muscle, vascular and neural components. In addition, there are neurological abnorma¬lities in the cerebral cortex and cerebellum that regulate the functioning of the verte¬bral column. The sum of the functional and tissue alterations modifies mechanical behavior both in the vertebrae (osteoporosis often complicated by fractures and de¬formities) than that of the intervertebral mobile segments, responsible for disc rupture, spondylolisthesis or degenerative deformities sometimes complicated by radicular or myelopathic abnormalities depending on the levels concerned. The impact of degene¬rative lesions in the spine is, however, highly variable from one subject to another depending on genetics, lifestyle, and for low back pain, the psychosocial context.