One of the advantages of aging, is having a time-line perspective that often scans decades and various upheavals or dramatic changes in human history.

I was reading The Handmaid's Tale by Margaret Atwood.

The first pets I had were dogs: first my grandmother's English sheepdog (Shaggy) and two mixed breeds…

Erika Leck, MD, PGY 5,¹, Sean D Christie, MD, FRCSC, ²,

CLINICAL TOOLS

• Abstract
• CME Quiz
• Visual Aids
• Key Points
• Clinical Pearls
• Premium Content

Abstract: The global population is ageing, and with that there is a concomitant increase in spinal pain and mobility complaints, most related to degenerative changes. It is important to consider how the markers of aging and, specifically, frailty, can overlap with symptoms of spine disease. Although non-operative management should be the initial response, spine surgery in older adults is safe and should be considered as part of a holistic approach for patients with persistent neuropathic pain.

Key Words: Spine Surgery, Elderly, Older Adults, Frailty, Imaging, Spinal Degeneration.

Members of the College of Family Physicians of Canada may claim MAINPRO-M2 Credits for this unaccredited educational program.

www.cfpc.ca/Mainpro_M2

You can take quizzes without subscribing; however, your results will not be stored. Subscribers will have access to their quiz results for future reference.

Pre-test CME Quiz Post-test CME Quiz

• 
• 

1. It is essential to remember that, while degeneration is inevitable, the appearance of symptoms is not and treatment decisions must be based on the clinical presentation, not the images.

2. Our ageing population will lead to an increase in the frequency of spine-related complaints.

3. It is important to consider how the markers of aging and frailty overlap with symptoms of spine disease.

4. The conservative approaches should always be pursued prior to consideration of surgical options.

5. When required, spine surgery in older patients is safe and efficacious, but should involve a healthcare team able to appropriately assess and support the patient and their loved ones.

1. Biological age does not necessarily equate to chronological age.

2. Radiological “abnormalities” become more common with age, but are frequently asymptomatic, order tests that direct care.

3. Combination, non-opioid, pharmacological strategies, with a ‘start low and go slow’ approach are preferred.

4. Tools such as the Clinical Frailty Scale can be helpful in predicting risk and clinical decision making.

To have access to full article that these tools were developed for, please subscribe. The cost to subscribe is $80 USD per year and you will gain full access to all the premium content on www.healthplexus.net, an educational portal, that hosts 1000s of clinical reviews, case studies, educational visual aids and more as well as within the mobile app.

Matt Farrah,

CLINICAL TOOLS

• Abstract
• Key Points
• Clinical Pearls
• Premium Content

Most of us either know about, have heard about or have experienced the existence of pecking order.