Spinal Osteoarthritis

Excerpt

Osteoarthritis is a common condition involving articular surfaces that can develop gradually over time into a debilitating condition that causes pain and restriction of motion. An estimated 80% of Americans have an episode of low back pain during their lifetime. Low back pain is among the most common causes of healthcare visits in the United States, accounting for over 45 million trips in 2006. Spine osteoarthritis is a significant source of chronic low back pain. While most cases of spine arthritis-related pain are self-limited, requiring only conservative therapy, chronic back pain treatment involves significant healthcare dollars. In 2016, patients in the United States spent an estimated $380 billion on low back and neck pain. $3.1 trillion, about 17.9% of the gross domestic product, was spent on this diagnosis.

Low back pain and spine arthritis are among the leading health-related causes of disability and reduction in patient quality of life. The number of back pain cases continues to increase with the current obesity epidemic and increased life expectancy. Furthermore, low back pain accounts for an estimated 149 million lost workdays each year in the United States. These lost wages substantially affect America’s gross domestic product. Due to the complexity of the innervation of the spine and its surrounding structures, delineating the cause of low back pain can be difficult. In approximately 85% of cases, the source of back pain is unknown. Also complicating the diagnosis is how radiographic imaging of spine osteoarthritis does not necessarily correlate with patients' pain, leading to treatment options that may not improve symptoms.

Arthritis can affect any articular surface; it is more likely to affect weight-bearing joints, including the joints of the spinal column. Functionally, the spine protects the spinal cord, sustains weight-bearing, and provides mobility. The spinal cord is composed of a three-joint complex. This complex consists of two facet joints (zygapophyseal joints), and one intervertebral disc, all of which are potential origins for back pain. These three components comprise a spinal motion segment, which facilitates degeneration over time. Degeneration forms vertebral osteophytes, facet joint osteoarthritis, and disc space narrowing. Specifically, spine osteoarthritis is the presence of disc degeneration and osteophyte formation.