Are Spine Problems Hereditary?

Some spine problems could have a genetic component. Here’s how to assess your risk.

If you’ve watched a parent struggle with back pain, you may wonder whether you’re destined for the same fate. The answer, according to Michael Safaee, MD, a neurosurgeon specializing in spine surgery at the USC Spine Center, part of Keck Medicine of USC, is more nuanced than a simple yes or no. 

The genetic connection 

“The most common spinal conditions are degenerative in nature, meaning they are a result of normal wear and tear, but there probably is a genetic component that makes certain people more susceptible than others,” Dr. Safaee says. 

In children and young adults, one of the more well-studied hereditary conditions is scoliosis, an abnormal side-to-side curvature. “There are genetic forms of scoliosis such as congenital scoliosis, and even adolescent idiopathic scoliosis likely has a genetic component, but our understanding of the exact genetic mechanisms is not completely understood,” Dr. Safaee says. 

Similarly, certain degenerative spine conditions can run in families. “If you have a family history of degenerative disc disease, anecdotally you may be at higher risk than someone who does not,” Dr. Safaee explains. However, he cautions that predicting who will actually develop these conditions remains difficult, and most spinal problems are simply a result of normal life. 

Spinal deformities and their genetic links 

The spine can bend abnormally in two directions: side-to-side (scoliosis) and front-to-back (kyphosis). Like scoliosis, Scheuermann’s kyphosis, a specific type of forward curvature, may be linked to mutations in certain genes. “Just like with scoliosis, there may be a genetic component to it, but we don’t fully understand the specific genes or exact inheritance pattern,” Dr. Safaee says. 

What researchers do know is that certain patients with scoliosis who go untreated may experience curve progression or develop arthritic changes below the curvature. These segments of the spine are put under additional mechanical stress.  

“Whether it’s the human body or the engine in your car, anything that is subjected to repeated mechanical stress is going to eventually wear down,” Dr. Safaee explains. 

Inflammatory conditions 

Ankylosing spondylitis, an inflammatory condition typically affecting the spine and sacroiliac joints (where the spine meets the pelvis), is another condition with hereditary associations. This form of spondyloarthritis is often undiagnosed until complications arise.  

“Many people don’t know they have it until they develop a fracture related to it,” Dr. Safaee notes. This condition underscores why understanding family medical history can be valuable for early detection.

Spinal tumors and genetics 

When it comes to spinal tumors, the genetic picture is a bit clearer.  

“In general, cancer comes in two forms when we’re talking about the spine,” Dr. Safaee says. Metastatic tumors, which spread from other parts of the body such as breast, prostate or lung cancer, account for about 80% to 90% of spinal tumors. These can have genetic risk factors — breast cancer’s link to the BRCA1 and BRCA2 gene mutations being the most well-known. 

For primary spinal tumors, the story is a bit different. “Certain tumors have associations with genetic syndromes such as neurofibromas, schwannomas and hemangioblastomas — although in general these are rare,” Dr. Safaee says. These tumors are associated with neurofibromatosis type 1 and type 2, schwannomatosis and Von Hippel-Lindau syndrome — all genetic syndromes. 

Assessing hereditary risk  

Having a family history of spine problems doesn’t guarantee you’ll develop them. It does, however, suggest you should be proactive about spinal health.  

If spinal conditions run in your family, consider these steps: 

• Share your family history with your primary care physician 
• Stay active with spine-friendly exercise like yoga to maintain core strength 
• Maintain a healthy weight to reduce stress on your spine 
• Monitor for symptoms like numbness, weakness or balance problems 

The need for further research 

“We don’t fully understand exactly how these conditions are passed down,” Dr. Safaee concedes. While genetic research is advancing, the interplay between genes and environment remains complex. What is clear is that a family history is one piece of a larger puzzle that includes lifestyle, injury history and age-related changes. 

“We suspect that, in general, if you have a family history, you may be at higher risk,” Dr. Safaee says. “But it’s hard to predict who will actually develop problems and who won’t. I advise all patients to live their life to its fullest, but if you have any concerns or symptoms, it is better to discuss them with your doctor sooner rather than later.” 

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Samantha Bonar

Samantha Bonar is a freelance writer for Keck Medicine of USC.

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