What is Spinal Osteopenia?
The clinical term “osteopenia” refers to have a lower bone mineral density (BMD) than the normal value when compared to others of the same age. Bone density shows the mass and strength of the bone. Osteopenia weakens your bone than normal level, but not that enough to break or fracture the vertebrae easily. Osteopenia itself will not produce any symptoms but as the condition worsens over time, the risk of other harmful bone conditions, like osteoporosis 1dramatically increases.
Osteopenia usually occurs after the age of 50, when bone density gradually decreases. You will get the highest bone density at the age of 30. Peoples with harder and dense bone will never get osteopenia. Women quickly develop osteopenia after menopause, due to lower estrogen levels. Prevention of osteopenia helps to protect the bones and reduce the risk of osteoporosis.
The major cause and risk factors of osteopenia include aging. After a certain age, your body will breakdown the old bone faster than it builds the new one. This results in the loss of some bone density. Several risk factors for osteopenia include modifiable factors (behavioral, such as dietary and use of certain drugs) and non-modifiable factors (for example, loss of bone mass with age). The more of these risk factors you have, the higher your risk to get osteopenia. Additional risk factors may include 2:
- Gender: Women quickly develop osteopenia after menopause, due to lower estrogen levels.
- Age: Maximum people lose about 0.5% of bone mass gradually every year after the age of 50.
- Hereditary: A family history of low BMD increases the risk of developing osteopenia at 50% to 85%.
- Lifestyle factors: This includes a poor diet with a lack of calcium and vitamin D, smoking, excessive drinking of alcohol or caffeine, inadequate exercises, taking certain medications like prednisone or phenytoin, etc.
- Other medical conditions: Celiac disease, Crohn’s disease, hyperthyroidism, hyperparathyroidism, anorexia nervosa, and Cushing’s syndrome may help to develop osteopenia.
How do neurosurgeons diagnose Osteopenia?
A survey of Harvard Medical School reveals that about 50% of all people over the age of 50 years in the United States have osteopenia. Data suggest that about one in every three white and Asian men over 50 years of age have low bone density 3.
The National Osteoporosis Foundation (NOF) and International Society for Clinical Densitometry (ISCD) recommends to do DXA (dual X-ray absorptiometry) test for lower BMD if you fulfill the following criteria 4,5:
- Older adults (both women and men) over 65 years of age
- Women younger than 65 years of age and postmenopausal
- Adults younger than 65 years of age and have one or more risk factors
Dual-energy X-ray absorptiometry (DEXA or DXA) test helps to measure the bone density levels in your spine, hip, wrist, or finger. This painless test uses X-rays with lower radiation than a typical X-ray. DEXA compares the density of your bone to the density of a young of 30 years of age of the same sex and race. T-score ranges between –1.0 to –2.5 show that you have osteopenia.
How do spinal specialists treat Osteopenia?
Non-pharmaceutical treatment of osteopenia involves preserving existing bone mass via adopting healthy behaviors such as a proper diet with good nutrition, exercise, avoidance of smoking or drinking alcohol, etc. Your doctor may suggest you take additional calcium or vitamin D supplement with a regular meal. In the case of a T score under -2, you need to do regular weight-bearing exercise and take additional vitamin-D and calcium supplements.
If the score comes closure to -2.5, your doctor will advise you to take certain medications to keep your bones strong. Pharmaceutical treatment for osteopenia may include includes a range of medications such as bisphosphonates (alendronate, risedronate, and ibandronate), selective estrogen receptor modulators (SERMs), etc. Please follow your doctor’s advice to maintain a healthy lifestyle during any age of your life.
- Varacallo, M. Osteopenia Osteopenia. (2018).
- Eriksen, E. F. Treatment of osteopenia. Rev. Endocr. Metab. Disord. 13, 209–223 (2012).
- Karaguzel, G. & Holick, M. F. Diagnosis and treatment of osteopenia. Rev. Endocr. Metab. Disord. 11, 237–251 (2010).
- Lems, W. F. et al. Osteopenia: A diagnostic and therapeutic challenge. Curr. Osteoporos. Rep. 9, 167–172 (2011).
- Pontes, T. A., Barbosa, A. D., Silva, R. D., Melo, M. R. & Silva, R. O. Osteopenia-osteoporosis discrimination in postmenopausal women by 1H NMR-based metabonomics. PLoS One 14, 1–10 (2019).