Samantha Olewnik

Biology of Aging Research Paper

Professor Kobre
April 30, 2013
Osteoarthritis of the Spine
There are many types of arthritis, the most common being osteoarthritis.
Osteoarthritis refers to arthritis of the joints, and a common place to develop this
condition is the spine. Sometimes called spinal arthritis, osteoarthritis of the spine
can turn into a painful, debilitating condition that leaves its victim immobilized and
sometimes causes a humped back.
The spine consists of a series of twenty four vertebrae which extend from the
skull down to the small of the back, enclosing a key part of the central nervous
system, the spinal cord. The spine, also referred to as the backbone, provides
support for the thorax and abdomen as well. The vertebrae in the spinal column
are cushioned and supported by disks of fibrocartilage. This type of cartilage is a
connective tissue that is stronger than the hyaline cartilage found on the ends of
long bones and the nose, but less flexible than the elastic cartilage that can be
found in the ear flaps and epiglottis. Unfortunately, as we age, this cartilage
between the disks in the vertebral column can start to deteriorate, causing the
spine to become misshapen. Coupled with an increasing loss of calcium from bones
with aging, including those in the spinal column, an older persons back can curve
into an abnormal hump shape. This deterioration, also known as osteoarthritis, can
cause the vertebrae to collapse in or slip forward on one another, adding to the
deformity (Gyoderpa).

Not only does osteoarthritis affect the cartilage in the spine, but it attacks
the joints as well. The joints in the spine are commonly called facet joints because
of their hinge-like dexterity in linking vertebrae together. These joints are synovial,
meaning that they are surrounded by a capsule of connective tissue and produce
fluid to nourish and lubricate the joint (Bridwell). The fibrocartilage in the spine
also serves to help the joints glide smoothly, or articulate, against each other,
allowing our backs to bend and move in various directions. Osteoarthritis results in
chronic inflammation that can cause the articular cartilage of these joints to
deteriorate. Symptoms associated with this type of inflammation include stiffness,
locking of the joints, overall joint pain, and sometimes effusions. The pain
associated with osteoarthritis can make it hard for someone to move their back at
all, forcing them into a hunched position, adding to the humped disfiguration. As
osteoarthritis progresses, the affected joints may appear larger, also making the
afflicted persons back seem larger than normal (Dorland). This disease generally
happens as people age, but younger people can also contract it after an injury or
because of a genetic defect involving the cartilage (Zelman).
Currently there is no single test to confirm a diagnosis of osteoarthritis, but
doctors may order a number of tests to aid in its diagnosis. X-rays can be done to
detect bone damage, loss of cartilage, or the misplacement of vertebral disks.
Blood tests may be run to exclude the possibility of other diseases, and a magnetic
resonance imaging scan (or MRI,) may be prescribed to show possible narrowing of
areas where spinal nerves exit due to the eroded cartilage or damage to vertebral
disks (Zelman).

For the most part, the treatment of osteoarthritis focuses on helping the joint
regain some functional ability and alleviating the symptoms of pain, working
towards an overall healthy lifestyle. It is recommended that everyone with
osteoarthritis maintain a healthy weight, and weight loss will be encouraged if
initially needed. Exercise is also likely to be prescribed as a form of treatment.
Besides helping with weight management, staying physically active can help
osteoarthritis sufferers increase flexibility, strengthen the heart, improve blood flow,
improve attitude and mood, and make daily tasks more accomplishable. Exercises
associated with the treatment of osteoarthritis are often broken up into three
categories: strengthening exercises, aerobic exercises, and range-of-motion
exercises. Strengthening exercises work to make the muscles that support the
afflicted joints stronger through the use of resistance with weights or rubber bands.
Aerobic exercises aim to make the heart and circulatory system stronger, while
range-of-motion exercises work to increase the bodys flexibility.
Non-drug treatments for osteoarthritis include massage, acupuncture,
applying heated or cold compresses to the afflicted site based on a doctors
recommendations, nutritional supplements, and transcutaneous electrical nerve
stimulation (TENS,) which is the use of a small device to emit electrical impulses
onto the affected joint. Over-the-counter drugs that may be used to treat the
disease include acetaminophen, certain non-steroidal anti-inflammatory drugs
(NSAIDs,) like aspirin and ibuprofen, and topical ointments and creams that are
applied directly to the skin of the area that hurts. NSAIDs can have serious side
effects, however, including stomach irritation and bleeding and kidney damage, so it
is advisable to consult a physician before starting any NSAID regimen. Prescription

drugs may also be recommended to help treat osteoarthritis, including prescription

painkillers, narcotics, or injections of corticosteroids, which are hormones
sometimes used to treat inflammation. Most cases of spinal osteoporosis can be
treated without surgery, but in the instances when the spinal canal has become so
narrowed that it impairs bladder and bowel function, walking, or the nervous
system in general has become damaged, joint replacement surgery will likely be
recommended (Zelman).
Because there isnt a cure for osteoarthritis currently, most research that has
been done focuses on the topic of rebuilding/ repairing the damaged joints or
cartilage or trying to mask the symptoms of the disease. One study suggests that
gelatin can actually rebuild the cartilage in the joints (Gez). According to the study,
because gelatin occurs naturally in the body and aids in the lubrication of joints and
the formation of cartilage, drinking 1 teaspoon melted in a half cup of water or juice
daily can help rebuild cartilage in the joints, lubricate the damaged joints, and
prevent further damage, allowing the cartilage to heal naturally. The study also
suggests that this regimen can aid in recovery after surgery.
Although these studies are useful in determining the best ways to attempt to
repair cartilage and joints damaged by osteoarthritis, as well as the most current
methods available to help alleviate the painful symptoms associated with the
disease, I feel that it would be much more conducive to the health of the patient to
research a way to prevent this degeneration from happening in the first place.
Discovering new ways to mask the pain is not helpful in actually fixing the problem;
it can in fact simply lead to bigger problems when the disease becomes worse after
numbing its warning signs.

If I had the ability to do so, I would conduct a study involving an injection of

chondroblasts directly to the cartilage in-between and surrounding the vertebral
disks. Because cartilage contains no blood supply, attempting to conduct a study
with a drug that must be ingested and travel through the bloodstream to reach its
destination would probably produce little results. Chondroblasts are specialized
cells that produce large amounts of extracellular matrix composed of collagen
fibers, proteoglycan, and elastin fibers, the three essential building blocks for any
type of cartilage (Pratt). Because cartilage is directly made up of these cells, I
think placing extra chondroblasts exactly where they are needed most would be
most helpful in preventing the damage associated with osteoarthritis from occurring
to the joints of the spine. If we placed a concentration of chondroblasts in an area
that we knew to be at risk for developing osteoarthritis in the future, maybe the
injected and natural chondroblasts could work together to strengthen the
preexisting cartilage, preventing it from wearing down and the joint from becoming
irritated.
I think the best way to test this sort of hypothesis would be to conduct a
longitudinal clinical study on the effects of injecting the cartilage around the
vertebrae with extra chondroblasts. I would gather volunteers between the ages of
30 and 40 to participate, as that is the age at which the early signs of osteoarthritis
may start to develop. The study participants would be split into two groups; one
would receive a yearly injection of chondroblasts into the fibrocartilage in their
spines, the other would simply be a control group that would receive no treatment
and be left to age naturally. Every year, tests would be run on the participants
(outside of the injection dates) to see whether or not they seemed to be losing any

cartilage, experiencing any deterioration, and how limber their backs felt in general,
including a test to see how wide of a range of motion they possessed in their backs.
This would go on for about twenty years, as by that time most participants would
be in their sixties, an age where it would be highly likely for the symptoms of
osteoarthritis to start becoming apparent in the control group or if the treatments
turned out to be useless. Hopefully this study would uncover that strengthening
the cartilage of the spinal column before any deterioration took place, instead of
trying to treat and cope with the loss of mobility that results from osteoarthritis
after the fact, is a better alternative to using drugs to hide the symptoms of the
disease. If we prevent deterioration and inflammation from having a chance to
occur by giving back-up to our fibrocartilage, hopefully the woe of osteoarthritis
could be solved. We wouldnt have to worry about coming up with safer ways to
treat the side effects of the disease because we would be able to prevent it from
ever happening in the first place.
Osteoarthritis of the spine is a severe condition that attacks the cartilage and
joints of the spinal column, leading to severe pain, stiffness, lack of mobility, and
the possibility of developing a hunchback due to the misplacement of vertebrae
following cartilage deterioration. There arent any cures for the disease yet, but
much research has been done trying to find ways to alleviate the associated
symptoms. This only masks the problem of the affliction, however, which can result
in it growing and the eventual destruction of the spines facet joints. I think that a
longitudinal clinical study involving the injection of additional chondroblasts to a
middle-aged persons spinal fibrocartilage could over time result in a strengthening
of the preexisting cartilage, preventing age-related erosion and deterioration and

eliminating the resulting possibility of joint inflammation and eventual drastic joint
replacement surgery. Even though osteoarthritis is not life-threatening, it can be
life-altering, as it dramatically alters a persons ability to function normally due to
its resulting lack of mobility. Any time someone has to change their lifestyle to
accommodate the symptoms of a disease that may be able to be prevented, action
must be taken to examine how we can fix it. I hope that we will someday see
research that focuses on preventing this crippling disease from happening in the
first place, not just on how we can comfort the patient; at that point its too late.

Bibliography
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