A cross-sectional autopsy study of the articular facet joints of 72 male and female cadavers found degenerative changes, including splitting, fissures, thickening and thinning of calcified cartilage and subchondral bone plates were associated with aging. Male subjects were more likely to demonstrate cartilage degeneration than females, though age-related changes were observed in both sexes. The degenerative changes noted appeared at all spinal levels where osseous structures of the cervical spinal facet joints or articular cartilage were involved. The study’s findings may be significant in understanding the progression of osteoarthritis.
Seeking to Better Understand Age-related Neck Pain
There are many possible causes for debilitating neck pain—a leading cause of disability worldwide. One possible cause of musculoskeletal neck pain is osteoarthritis—particularly, that of the cervical spine facet joints. A better understanding of the mechanisms involved in neck pain and how gender may influence the development and progression of cervical neck pain is necessary.
Researchers obtained C4-C7 spinal segments from 29 female, and 43 male cadavers to evaluate morphological and histomorphometric variables of 1132 articular facets. The mean age of the female cervical samples was 53 years, and the male samples were roughly 38 years old. A linear regression model was used to analyze the microscopic examination and random sampling data retrieved during the study.
Age-related Bone and Cartilage Changes More Prominent in Men, but Evident in All
The male samples involved in this study demonstrated more extensive cartilage degeneration than the female cervical samples. Statistically-significant increases in fissures, splitting, osteophytes, calcified cartilage and subchondral bone plate thickness were associated with aging in the data analysis. This was true at all levels of the cervical spine that involved osseous structures of the facet joints and articular cartilage. Overall, there were few differences between the male and female subject samples when it came to histomorphometric variables, including a gradual increase of subchondral bone and cartilage thickness and a decrease of hyaline articular cartilage thickness with age. This could indicate that age-related degeneration of these structures follows a similar path in both genders. The results indicate that there is an increase of 2 percent per decade in cartilage thickness, which suggests that endochondral ossification is involved in the pathology of osteoarthritis. The findings also indicated that increasing age was related to an increase in subchondral sclerosis and the development of osteophytes in the articular skeleton. The maximum cartilage length also increased by .56 mm per decade, or roughly 4 percent per person and was more pronounced in male samples than in female ones. The presence of synovial folds was similar in all male and female samples aged 20-79 years.
Multifactorial Approach to Neck Pain in the Elderly Recommended
Although it seems probably that OA changes in the cervical spine may be linked to neck pain in the aging population, the exact mechanisms involved in the development of neck pain remain unclear. Women over the age of 45 are more likely than their male counterparts to report neck pain, but this study found that aging males are more prone to cervical degenerative changes than females, indicating that there may be other causes besides OA of the facet joints when it comes to neck pain in the elderly population. The authors of the study recommend practitioners take a multifactorial approach when it comes to diagnosing and treating neck pain in the elderly.
A study of lower cervical spine facet joints in cadavers suggests the causes of neck pain in the aging –one of the leading debilitating musculoskeletal conditions— are multifactorial and should be treated as such. Researchers found strong evidence that a progressive thickening of cervical joint cartilage in the aging population could play a role in the development of cervical osteoarthritis, particularly in men, whose spinal sample degeneration was more severe than that of the female subject samples. However, since women are more likely than men to complain of neck pain after the age of 45, the findings highlight the need for practitioners to osteoarthritis only one of many possible causes when diagnosing and treating neck pain in the elderly.