Surgical Indication and Fusion Surgery for Degenerative Lumbar Spine Disease

Abstract

  Incidence of degenerative spine disease has been rapidly rising with the advent of our aging societies. Symptoms associated with degenerative spine disease have a negative impact on the activities of daily living of elderly individuals, discourage social participation, and decrease their quality of life, while inducing psychological disorders. Thus, finding long-term preventive strategies for elderly individuals is a major challenge faced by our society.

  In terms of long-term preventive care for elderly individuals and extension of the healthy human lifespan, coping with these symptoms is important. However, the evidence for selecting the best approaches such as symptomatic treatments (providing fast-acting benefits or alleviating pain) and surgical treatments (achieving decompression of constrictions) is still scarce.

  The number of surgeries for degenerative spine disease has been increasing in recent years. One of the reasons for this is the availability of minimally invasive surgical treatments along with the evolution of surgical devices. The indications for minimally invasive spinal surgery in elderly patients who cannot undergo conventional surgical procedures have increased, but careful selection of cases is still needed.

  Degenerative spine disease involves static (ligamentum flavum, intervertebral disc, facet joint, and vertebral body) and dynamic factors (posture, movements, spinal instability, and spinal misalignment). Additionally, age-associated degenerative changes induce anatomical spinal changes (in the ligamentum flavum, the intervertebral disc, etc.) that differ from the characteristics present in intracranial disorders. Therefore, neurosurgeons need to consider this fact while diagnosing spine disorders.

  Here we report an overview of the pathophysiology of degenerative spine disease along with a literature review of surgical indications and specific procedures.