Osteoporosis

Osteoporosis and Spinal Fractures Overview:

Osteoporosis is a condition that causes a thinning of the bones. osteoporosis1This can result in vertebral compression fractures, deformity (kyphosis) and even death. Osteoporosis and related spine fractures are largely treatable and preventable with medications, calcium intake, and kyphoplastyor vertebroplasty surgery.

Osteoporosis Symptoms:

Because osteoporosis is a “silent” disease, meaning that there areosteo_po2 typically no symptoms until a fracture occurs, it is not uncommon for someone with back pain to be unaware of the fact that he or she has actually fractured a vertebra (or multiple vertebrae) in their spine.

Typical Compression Fracture Symptoms:

The main clinical symptoms of vertebral fractures typically include one or a combination of the following symptoms:

  1. Sudden onset of back pain
  2. Standing or walking will usually make the pain worse
  3. Lying on one’s back makes the pain less intense
  4. Limited spinal mobility
  5. Height loss
  6. Deformity and disability

As a general rule, a compression fracture should be suspected in any patient over the age of 50 with acute onset of back pain. For women, especially those with risk factors for osteoporosis, many physicians believe that a vertebral fracture should be suspected in any women over age 45 with sudden onset of back pain.

Osteoporosis Causes:

Osteoporosis is a disease caused principally by the significant loss of bone mineral density (BMD). Early in life, more bone is laid down than is removed, and an individual’s peak bone mass is typically achieved by around age 30. After peak bone mass is reached, the remodeling process (the process of laying down new bone and removing old bone) takes away more bone than is replaced. Hence making the bones more prone to osteoporosis (and consequently to fracture).

Osteoporosis Treatment:

Once the appropriate medical history, physical exam and diagnostic tests have been obtained and a diagnosis of primary osteoporosis has been made, treatment is warranted. Treatment for osteoporosis typically includes education on diet/nutrition, exercise (if no fractures) and medications. The goal of osteoporosis treatment is to prevent fractures.

There are a number of medications to treat osteoporosis and help reduce the risk of fractures. In general, these medications work by helping to strengthen the bones and prevent further bone loss. Medications currently approved by the U.S. Food and Drug Administration for the prevention and/or treatment of osteoporosis are:

  •   Osteoporosis medications that slow or stop bone resorption
  •   Bisphosphonates
  •   Calcitonin
  •   Selective Estrogen Receptor Modulators, e.g., Raloxifene
  •   Estrogen/hormone therapy
  •   Osteoporosis medications that increase bone formation
  •   Teriparatide, a parathyroid hormone

Balloon Kyphoplasty: Clinical Evidence for Treating Spinal Fractures:

New clinical trial results have been released summarizing the findings from a large, multicenter, randomized, controlled clinical trial comparing balloon kyphoplasty with non-surgical care for the treatment of acute vertebral compression fractures. Nonsurgical treatment options for vertebral fractures typically include pain medications, bed rest, back braces, physical therapy, rehabilitation programs and walking aids.

In most cases, compression fractures are caused by osteoporosis and result in one or a combination of the following symptoms: severe back pain, limitations in ability to function in everyday activities, and poor quality of life (such as extended bed rest).

 It has resulted in three general conclusions about treatment:

  •   The patients treated with balloon kyphoplasty had significantly better outcomes in terms of pain reduction, quality of life, function and mobility both initially, at one month, and throughout the first 12 months after treatment, compared to non-surgical care.
  •   These study findings suggest that balloon kyphoplasty may be considered earlier in the course of spinal fracture treatment.
  •   The study confirmed results of earlier studies that balloon kyphoplasty is a relatively safe and effective method of treating painful vertebral compression fractures as compared to nonsurgical treatment.