| With the rapid growth of the elderly population, osteoporosis (OP) has become one of the most pressing public health and medical challenges. OP is a systemic bone disease marked by reduced bone mass and microstructural deterioration, resulting in weakened bone strength, increased fragility, and a higher risk of fractures. OP weakens bone structure to the point that even normal daily activities can place undue stress on the vertebrae. This loss of structural integrity is caused not only by reduced bone density but also by alterations in bone structure, remodeling, and repair, leading to quicker damage accumulation under repetitive stress. Normal trabecular bone is replaced by thinner, sparser, needle-like structures, making the bones more fragile. Furthermore, the loss of horizontally cross-linked struts weakens vertical trabecular buckling strength, resulting in more porous cancellous bone. In osteoporotic patients, fractures dramatically decrease quality of life and can be debilitating or even fatal. OP contributes to disc degeneration, narrowing of intervertebral spaces, joint degeneration, and disrupted bone remodeling processes. These degenerative changes can lead to worsening spinal deformities and potentially cause neurological damage. Altered stress distribution may result in degenerative instability and subluxation, contributing to conditions such as scoliosis, spinal stenosis, and lumbar spondylolisthesis. This study systematically reviewed the literature to assess the effects of OP on the spinal motor unit, aiming to provide a comprehensive summary of its current impact. |