Osteoporosis of the Spine

Osteoporosis is a bone disease characterized by a decrease in bone mass and density resulting in brittle, fragile bones that are more susceptible to fractures. The condition most commonly affects elderly women. Osteoporosis-related fractures are more common at the vertebral bodies of the spine. Osteoporosis is called a "silent disease," as a majority of the patients may be unaware of their condition until they develop a bone fracture.

The factors that increase the risk of developing osteoporosis include:

  • Women are at a higher risk than men
  • Family history of osteoporosis
  • Aging
  • Thin and small body frame
  • Low levels of estrogen and post menopause
  • Certain endocrine disorders such as diabetes
  • Medical conditions such as rheumatoid arthritis, cancer, and malabsorption syndromes or malnutrition
  • Some medications such as steroids, immunosuppressant, anticoagulants, antiepileptic and thyroid suppressive therapy

Osteoporosis in the spine can weaken bones and result in compression fractures, where the front of the bone collapses causing the spine to curve into a hunchback with loss of height. It may also cause pain, gastrointestinal and breathing problems, and disturbed sleep.

An accurate diagnosis of osteoporosis is essential to prevent future spinal compression fractures and to maintain a healthy spine. Your doctor will arrive at the diagnosis of osteoporosis based on the medical history, physical examination and neurological examination to evaluate your muscle strength, reflexes and sensations. X-rays, MRI, CT and bone scans of the spine may show fracture of the vertebrae. Your doctor may also order a bone densitometry scan, also called dual energy X-ray absorptiometry (DEXA) to measure bone density using a very low dose of X-ray.

Osteoporosis cannot be cured, but can be managed. Treatment is based on the patient’s age, gender, fracture risk and bone status. There are different treatment options available for the management of osteoporosis including lifestyle changes, weight bearing exercises, calcium and vitamin D supplements, hormone replacement therapy, and medications to stop bone loss and strengthen bones. Pain medications and spinal bracing are often recommended. When these methods fail to relieve symptoms, your surgeon may perform kyphoplasty, where a small deflated balloon is inserted into the fractured vertebra and inflated to restore its height, or vertebroplasty, where cement is injected into the narrowed vertebra.

Osteoporosis can be controlled and the complications can be prevented if detected early. Some of the preventive measures that can help reduce the risk of developing osteoporosis include:

  • Consume a healthy well balanced diet
  • Get adequate amounts of calcium and vitamin D
  • Avoid excessive alcohol intake and smoking
  • Exercise regularly

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