Osteoporosis

What is Spinal Osteoporosis?

The term “Osteoporosis” refers to have a lower bone mass density because of bone tissue deterioration and disruption of bone micro-architecture. This condition compromises the bone strength and increases the risk of fractures. An osteoporotic bone becomes weak and brittle so that this can easily break down. This condition mostly occurs in the hip, wrist, and spine. Osteoporosis in the spinal bone may cause a fracture in any location, ranges from cervical to sacrum ¹.

Osteoporosis itself will not produce any symptoms in the early stages of bone loss. But once your bone becomes weakened by osteoporosis, the symptoms will pop up. Symptoms of osteoporosis may include back pain because of fractured vertebrae, height loss, abnormal or stopped posture, curved spine, and difficulties in breathing in case of vertebral crush fracture.

Osteoporosis affects men and women of all races. Like osteopenia, the major cause and risk factors of Osteoporosis include aging. Several unchangeable risk factors like age, sex, body condition, family history, race, etc. may contribute to developing osteoporosis among people. Additional risk factors may include ²:

• Hormone level: Lack of estrogen may increase the risk of osteoporosis in older women.
• Dietary factors: Diet containing a lack of calcium plays a role in the development of osteoporosis. Several eating disorders and gastrointestinal surgery to reduce the size of your stomach may help to develop this condition because of the lower intake of nutrition.
• Lifestyle choices: Heavy smoking, excessive consumption of alcohol and a sedentary lifestyle can increase your risk of osteoporosis.
• Steroids and other medications: Long-term use of medications like prednisolone and cortisone interferes with the proper bone-building process.
• Several medical conditions: Celiac disease, rheumatoid arthritis, lupus, cancer, kidney or liver disease, inflammatory bowel disease (IBD), multiple myeloma, etc. may help to develop osteoporosis.

How do Neurosurgeons Diagnose Spinal Osteoporosis?

A bone density test can help you to determine whether if you have osteoporosis. Your doctor may perform this test to predict the risk of bone fracture. A bone densitometer that produce a low-energy X-ray beam used for this test. The principle of this test includes comparing the amount of X-ray energy that enters the bone with the amount of energy that leaves the bone. The denser bone will absorb more energy ³.

Different types of central densitometer may include dual-energy X-ray absorptiometry (DXA) and quantitative computerized tomography (QCT) and peripheral densitometer includes a quantitative ultrasound (QUS), peripheral dual-energy X-ray absorptiometry (pDXA), and peripheral quantitative computerized tomography (pQCT) ⁴.

The U.S. Preventive Services Task Force recommends that all older adults of 65 years should perform a bone density test. The type of bone density test depends on your age. In the case of osteoporosis, most doctors prefer scheduled periodic DXA tests.

How do Neurosurgeons Treat Osteoporosis of the Spine?

Treatment for osteoporosis typically involves preserving existing bone mass via lifestyle changes to a proper diet with good nutrition and exercise. Your doctor may suggest you to take medications that slow down the rate of bone-breaking and increase the rate of bone formation. Sometimes, you need to take additional vitamin-D and calcium supplements with your regular meal. Along with these, regular exercise may help you to prevent this condition. Experts suggest that exercise can help to maintain bone density and provide muscle strength ⁵.

Medications for osteoporosis may include analgesics (paracetamol, codeine, and occasionally morphine), non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen, and bisphosphonate (alendronate, risedronate, and ibandronate). In the case of experiencing a painful vertebral compression fracture, the doctor may advise to perform surgeries like kyphoplasty or vertebroplasty. Please follow your doctor’s instructions to maintain a healthy lifestyle during any age of your life.

References

1. Lau RY, Guo X. A Review on Current Osteoporosis Research: With Special Focus on Disuse Bone Loss. Journal of Osteoporosis. 2011;2011:1–6. doi:10.4061/2011/293808
2. Deal CL. Osteoporosis : 9343(97).
3. Juli. Osteoporosis: A review. Research Journal of Pharmaceutical, Biological and Chemical Sciences. 2016;7(4):2853–2856. doi:10.3329/birdem.v5i1.28371
4. Sozen T, Ozisik L, Calik Basaran N. An overview and management of osteoporosis. European Journal of Rheumatology. 2017;4(1):46–56. doi:10.5152/eurjrheum.2016.048
5. Pisani P, Renna MD, Conversano F, Casciaro E, Di Paola M, Quarta E, Muratore M, Casciaro S. Major osteoporotic fragility fractures: Risk factor updates and societal impact. World Journal of Orthopaedics. 2016;7(3):171–181. doi:10.5312/wjo.v7.i3.171