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2026, Number 1

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Cir Columna 2026; 4 (1)

Bone Health in the 21st century: biology, function, and resilience for a ''Universal Clinical Definition''. SILACO Research Group

Salcido RMV, Bazán PL, Yurac BR, Diez UMA, Duchén RLM, Marré CA, Romero GPA, Jiménez ÁJM

Language: Spanish
References: 26
Page: 33-40
PDF size: 427.24 Kb.


ABSTRACT

Introduction: bone diseases represent a global challenge, due to their economic and social impact on the quality of life of millions of people. Their development is silent and progressive. Unfortunately, diagnosis often comes too late, when the consequences are already irreversible. Therefore, it is urgent to conceptualize bone health comprehensively, establishing clear criteria for early evaluation and prevention. The gap between silent deterioration and late diagnosis is worsened by the lack of a universal definition of spinal bone health. Establishing a clear and practical concept of bone health, with a focus on spinal bone health, would enable timely diagnosis, effective treatments, and –most importantly– reduce complications and improve quality of life in spine surgery. Material and methods: a systematic review was conducted in major databases (PubMed, Scopus, LILACS, Cochrane) using terms like “bone health”, excluding studies on osteoporosis, fractures, or specific populations. Inclusion criteria: all article types except case reports (2014-2024 filter). All languages were considered. Results: a total of 214 articles were retrieved; duplicates were excluded. An analysis was performed prioritizing studies exploring implicit or explicit definitions of bone health, resulting in 87 relevant studies. Most came from the U.S. (15), China, and the UK 69% were in English, with 55 narrative reviews and only 13 systematic reviews. Conclusions: bone health is a comprehensive concept referring to the optimal state of skeletal tissue-morphologically (macro- and microarchitecture), physiologically, and biologically (cellular function)–enabling it to withstand physiological stress and demands (bone resilience) through homeostasis (a continuous and balanced remodeling process). This ensures a satisfactory quality of life according to age and adjusted for aging. Spinal bone health is defined as the integrated capacity of each vertebra to withstand complex physiological loads (axial compression, flexion, torsion), protect the spinal cord and nerve roots, and serve as a viable biological and mechanical anchor for surgical instrumentation while promoting an environment conducive to bone fusion (arthrodesis).


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