Sarcopenia and osteoporosis are prevalent age-related musculoskeletal disorders that frequently coexist and interact, giving rise to the clinical entity known as osteosarcopenia. Although traditionally considered distinct entities, growing evidence indicates that muscle and bone are functionally integrated through biomechanical and biochemical crosstalk. Sarcopenia is characterized by progressive loss of skeletal muscle mass, strength, and function, whereas osteoporosis is defined by reduced bone mineral density (BMD) and microarchitectural deterioration, resulting in increased fracture risk. Both conditions share common risk factors, including aging, chronic inflammation, hormonal changes, physical inactivity, and nutritional deficiencies. Emerging evidence highlights the important role of muscle-derived myokines, bone-derived osteokines, and adipokines in mediating inter-organ communication within the musculoskeletal unit. This narrative review synthesizes current evidence supporting osteosarcopenia as an integrated musculoskeletal syndrome, with a particular focus on biomechanical loading, biochemical crosstalk, and inflammatory signaling. In addition, we discuss diagnostic challenges and therapeutic strategies, emphasizing integrated assessment and management approaches that target skeletal fragility, muscle dysfunction, and musculoskeletal interfaces to reduce frailty, falls, and fractures in aging populations.
Jeonghyeon Seo, Sang Hoon Hwang, Ji Yeon Yoon et al.· Journal of Korean Neurosurgi...· 0 citations
Thoracolumbar trauma in elderly patients has become increasingly important as population aging has reshaped the epidemiology of spinal injury. In the aging spine, low-energy trauma can produce clinically significant or unstable fractures because osteoporosis, degenerative stiffness, and rigid spine disorders alter mechanical behavior. Conventional classification systems and guideline-based algorithms remain useful for describing fracture morphology, neurological status, and structural instability. However, their applicability in elderly patients is limited because treatment decisions must account for frailty-related vulnerability and the functional consequences of immobilization. This review summarizes the distinctive features of thoracolumbar trauma in the aging spine and proposes an integrated framework that combines structural injury severity with frailty-based assessment of treatment tolerance. Frailty reduces physiologic reserve and limits the ability to tolerate treatment and recover after injury, while poor bone quality and spinal rigidity increase the risk of structural failure even with guideline-concordant care. Treatment should aim to restore stability, preserve neurological function, control pain, and enable early mobilization while minimizing physiologic burden. Depending on structural demand, treatment may range from non-operative care or vertebral augmentation in appropriate patients to definitive fixation, with selection guided by bone quality, frailty, and expected functional benefit. Thoracolumbar trauma in the aging spine should be managed as a distinct clinical entity for which an integrated frailty-based framework may better support practical, patient-centered decision-making.
Seung-Hoon Lee, Matthew W. Scarsbrook, Joonho Byun et al.· Journal of Korean Neurosurgi...· 0 citations
We use cookies to run the site and, with your consent, for analytics and to show ads.
See our Cookie Policy.
