Diagnostic imaging for spinal disorders in the elderly: a narrative review

According to the United States Census Bureau, between the years 2000 and 2010, the United States (US) population aged 45 to 64？years and 65？years and over grew at rates of 31.5 percent and 15.1 respectively [1]. This rapid growth in the aged population is a consequence of an increase in life expectancy as well as the “Baby Boom” generation. Every year over 3.5 million baby boomers in the US turn 55 leading to predictions that by 2035, 20 percent of the population will be 65 or older [2]. A similar trend is observed in Australia where the proportion of the population aged 65？years and over increased from 11.1？% to 13.5？% between the years 1990 and 2010 [3]. Unsurprisingly, this aging trend is associated with an increased use of health care services for a number of heath conditions.For instance, neck pain (NP) and low back pain (LBP) are common complaints in seniors, leading to impaired functional ability and decreased independence. A recent cross sectional study suggests between 10-20？% of seniors over the age 70 reported more than 30？days of NP or LBP within the past year, with a significant proportion having diminished their physical activities due to NP (11？%) or LBP (15？%) within the past year [4]. Poor overall physical function, bad self-rated health, and higher depression scores have been associated with higher prevalence of neck and back pain [5]. Most neck and back pain sufferers seeking help consult primary care professionals, including chiropractors [6,7].Chiropractors specialize in managing musculoskeletal disorders and reviews have indicated that this approach is as effective and safe as conventional medical care and physiotherapy for back pain [8-10]. When combined with other modalities such as exercise, chiropractic care appears to be more effective than other treatment approaches for patients with chronic neck pain [9,11,12]. For acute and subacute neck pain, cervical manipulation appears to be more effective than medication in both the short and long