Osteoporosis

Basic Facts

Osteoporosis is a condition in which bones decrease in density over time, weakening them and leaving them at risk for fractures.
Osteoporosis initially causes no symptoms; the first symptom a person may experience may occur when a bone collapses or breaks.
Treatments for spinal fractures caused by osteoporosis include vertebroplasty and kyphoplasty.

Osteoporosis is a condition in which bones decrease in density over time, weakening them and making them susceptible to fractures. Bones contain minerals such as calcium and phosphate, which make them hard and dense. To keep bones dense, the body needs adequate amounts of these and other minerals, as well as certain hormones. In addition, people need vitamin D to absorb calcium. Although many consider osteoporosis to be a condition of the elderly, it is a gradual process that begins in a person's late 20s or early 30s. If left untreated, osteoporosis can cause fractures in the bones, which occur most often in the hips, spine, and wrist. Fractures in the spine can cause loss of height, severe back pain, and deformity.

WHAT ARE THE SYMPTOMS?
Osteoporosis initially causes no symptoms. As the disease progresses, it can cause dull pain in the bones or muscles, especially in the lower back and neck. Later in the course of the disease, it can cause sudden sharp pain that may worsen when pressure is put on the area and that may last for several months. A broken bone is often the first sign of osteoporosis.

CAUSES AND RISK FACTORS
Factors that increase the risk of osteoporosis include:

Female sex;
Advancing age (older than 45);
Family history of osteoporosis;
Being past menopause;
Abnormal absence of menstrual periods;
Anorexia or bulimia;
Inadequate calcium intake;
Long-term use of medications such as corticosteroids or anticonvulsants;
Lack of exercise, especially weight-bearing exercise;
Smoking; and
Excessive alcohol use.

DIAGNOSIS
To diagnose osteoporosis, physicians often use bone mineral density (BMD) tests using one of several types of machines, most of which use x rays. For most BMD tests, the patient lies on a cushioned table as a scanner passes over his or her body. These machines include:

Dual-energy X-ray absorptiometry (DEXA) (uses electromagnetic radiation to estimate bone density in your spine and hip);
Single-energy X-ray absorptiometry (SXA) (uses electromagnetic radiation to measure heel and forearm bone density);
Peripheral dual-energy X-ray absorptiometry (P-DEXA) (uses electromagnetic radiation to measure the density of bones in the arms or legs, such as the wrist);
Dual photon absorptiometry (DPA) (uses a radioactive substance to measure bone density in the hip and spine);
Ultrasound (uses high-frequency sound waves to create images of the body, usually in the heel); and
Quantitative computed tomography (QCT) (uses x ray technology and a computer monitor to measure the density of a bone in the spine [vertebra]).

TREATMENT APPROACH
Treatment for osteoporosis focuses on slowing the progression of the disease, preventing bone fractures, and controlling pain. It can include lifestyle changes such as consuming adequate amounts of calcium and performing weight-bearing exercise. In addition, patients may be given medications, such as hormone replacement therapy, bisphosphonates, as well as calcium and vitamin D supplements.

To treat spinal fractures, the physician may perform vertebroplasty or kyphoplasty.

Vertebroplasty. Vertebroplasty is a nonsurgical, minimally invasive procedure that is used to treat one or more broken vertebrae. In this procedure, the physician makes a small incision in the back and inserts a needle through a nick in the skin in the back. Using continuous moving x-ray technique called fluoroscopy, the physician guides the needle into the fractured vertebra. The physician then injects a medical-grade bone cement into the vertebra. The cement hardens in about 15 minutes, stabilizing the fracture.

To learn more about vertebroplasty, click here.>

Kyphoplasty. Kyphoplasty is similar to vertebroplasty, but the physician uses a balloon while vertebroplasty does not. In this treatment, a small balloon is inflated in the inside of the broke vertebra to restore its shape and a special type of cement is then injected into a broken bone to stabilize it.

To learn more about kyphoplasty, click here.>