Osteoporosis is a disease that affects women more than men, especially postmenopausal women. Worldwide, 1 in 3 women and 1 in 8 men over age 50 have osteoporosis. Its risk factors include a diet lacking in Calcium and Vitamin D, certain medications such as corticosteroids, excessive alcohol consumption and smoking. It causes bones to become thin and weak, which frequently results in the hip, wrist and spine fractures.

To detect osteoporosis, primary care physicians or orthopaedic specialists will order a specialized test known as a DEXA (Dual Energy X-ray Absorption) Bone Densitometry scan The DEXA scan is a non-invasive test that takes specialized X-rays of your wrist, spine and hip to determine your bone density. When the results come back, the doctor may describe your results in one of three terms: Normal, osteopenia (slight loss of bone density) or osteoporosis. In addition to the DEXA scan, your doctor and you may consider ordering a blood test to analyze the amount of VitaminD in your system. Vitamin D is important because a deficiency may cause decreased bone density.

While there is no cure for osteoporosis, treatment includes a variety of medications and lifestyle modification including:

• low level weight bearing exercise
• a diet rich in calcium and Vitamin D
• quitting smoking

Medications include over-the-counter vitamin supplements, prescription medications (Fosamax, Actonel, Boniva), and hormone replacement.

What is a spinal compression fracture?

Osteoporosis is the leading cause of spinal compression fractures, also called vertebral compression fractures. This type of spine fracture may occur in the mid (thoracic) or lower (lumbar) back and can lead to a condition known as kyphosis, where the back becomes rounded or hunched because of the collapse of the front part of the vertebrae.  Spinal fractures are common. It is estimated that 700,000 spinal fractures per year occur in the U.S of only which one-third are diagnosed. Fractures can cause significant pain and prevent performing routine activities.

Normal Vertebrae

Fractured Vertebrae

Spinal compression fractures can be a debilitating and painful condition leading to a chronic pain and can cause poor appetite, inability to breathe deeply and difficulty sleeping. After one spinal fracture has occurred, there is a very high risk for developing another fracture. In addition, if walking and general movement is difficult, there is a greater risk of falling and sustaining other injuries such as breaks of the hip or wrist.

Spinal fractures have traditionally been treated with bed rest, pain medication, bracing and surgical procedures. Recently developed minimally invasive surgical procedures may offer an alternative to current treatments for some patients.

Minimally Invasive Procedures

Recently, two minimally invasive surgical procedures have been developed and are used to treat spinal fractures. ‘Minimally invasive’ means no large incisions are made.

Vertebroplasty is a minimally invasive procedure that treats spinal fractures. It is designed to stabilize fractured vertebra by injecting bone cement into damaged vertebrae. Physicians use imaging devices (tiny cameras project images onto monitors that look much like TV screens) to guide tools to the fractured vertebra.

Balloon Kyphoplasty is another minimally invasive treatment option for patients with spinal fractures. Baloon Kyphoplasty may offer reduction of pain and increased mobility. Two small incisions are made in the patient’s back and a pathway is created to the vertebrae. Spinal cement is then injected into the vertebrae in an attempt to return it to the correct position.

Both procedures may prevent further collapse of the vertebra thereby preventing the height loss and spine curvature, sometimes referred to as "Dowager’s Hump."

If osteoporosis-related spinal fractures are not treated, vertebrae may heal in an unnatural shape. If vertebrae heal in this manner, they likely will not be able to be treated effectively.

Fractured vertebra can lead to 'Dowager's Hump'

Who might benefit from minimally invasive procedures?

You may be a candidate for either if these procedures if you experience pain as a result of an osteoporotic spinal compression fracture. As always, you and your doctor will need to discuss and evaluate your condition to determine if you are a candidate for either procedure. Your doctor will likely determine if a minimally invasive procedure will help you by:

• Discussing your medical history
• Performing a physical examination
• Determining your overall medical condition
• Identifying the type and location of any fractures you may have already sustained
• Conducting various imaging tests including X-ray, MRI and Bone Scan

Also, patients who experience fractures from diseases such as multiple myeloma or metastatic cancer may be candidates for a minimally invasive procedure.

So if you, or someone you know, experiences persistent spinal pain, consult your physician or health care provider.

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