The balance between stability and mobility defines the spinal column.
Age-related changes affect all components of the spine. Its core tasks are affected: even stability is impaired by progressive fragility in senile osteoporosis and continues with the increase in segmental mobility due to degenerative processes in the area of the disc and the facet joints.
The degenerative process begins very early, during the first decades of life, in the disc area, long before it starts to become symptomatic because of the summation of multiple small traumata. It is not until the intervertebral disc loses height after a corresponding loss of its water-binding capacity that the facet joint is functionally affected. If, as a consequence of hypertrophy of the facet joints, reactively occurring spondylophytes, disc lesions and reactive hypertrophy of the ligamenta flava, a narrowing of the spinal canal occurs, typical symptoms of spinal stenosis can appear. Further progression of the degenerative process can result in more structural loosening and formation of de novo degenerative scoliosis. This can lead to a massive biomechanical disruption and the inability to fulfil the main tasks of load-bearing and functionality.