Similarly, as altered mechanics place greater stresses on the zygapophysial joints, osteophytes develop along the attachments of the joint cap- sules and accessory ligaments, especially those of the superior articular process, whereas extensions of the articular cartilage develop around the articular facets of the inferior processes.
This bony or cartilaginous growth during advanced age has traditionally been viewed as a disease process (spondy- losis in the case of the vertebral bodies, osteoarthrosis in the case of the zygapophysial joints), but it may be more realistic to view it as an expected morphological change with age, rep- resenting normal anatomy for a particular age range.
Correlation of these findings with pain is often difficult. Some people with these manifestations present with pain, others demonstrate the same age-related changes but have no pain, and still others exhibit little morphological change but complain of the same types of pain as those with evi- dent change. In view of this and the typical occurrence of these findings, some clinicians have suggested that such age- related changes should not be considered pathological, but as the normal anatomy of aging.