Neurological Spine Disorders

Osteoporotic Fractures

Osteoporotic FracturesWhat is an osteoporotic fracture?

Osteoporosis is a condition in which the bones become more fragile due to bone deterioration or low bone mass. Bones that are weaker or more fragile are at greater risk for fractures. Fractures occur commonly in the spine. Bone loss can occur without any symptoms, until the fracture actually occurs. These fractures can arise with minimal trauma, such as a strain, bump or fall.

In individuals with osteoporosis, a fracture can be caused by even a minor fall or during routine activities, such as twisting and bending. Typically, significant back pain along the spine is experienced after a fracture happens.

How common are osteoporotic fractures?

10 million Americans have osteoporosis, and 34 million individuals over the age of 50 are at risk of developing osteoporosis. More than 700,000 vertebral body compression fractures occur per year in the United States. Half of all women and a quarter of all men over the age of 50 will experience an osteoporosis-related fracture at some point in their lifetime. 50 percent of these fractures are spinal fractures.

80 percent of the individuals who have osteoporosis are women and the condition occurs more often in older individuals, but can also occur in men, and also at any age.

What are the risk factors for an osteoporotic fracture?

1. Low body weight
2. Cigarette smoking
3. Family history of osteoporosis
4. Drugs such as alcohol, anti-epilepsy medication and steroids
5. Being postmenopausal
6. Physical inactivity
7. Low calcium intake
8. Being thin or having a small frame
9. You or your first degree relative experiencing a prior low-trauma vertebral body fracture

A bone density screening can be useful in helping certain individuals determine their risk level. Factors that reduce your risk of osteoporosis include impact exercise.

How are osteoporotic fractures treated?

Treatment for osteoporotic fractures includes pain medication, external bracing, vertebroplasty and occasionally surgery.

Bracing is done to help with pain control for stable fractures or those at extremely high risk and unable to tolerate a surgical procedure safely. Pain usually improves in four to six weeks.

Vertebroplasty is used when severe pain cannot be controlled with oral pain medicine or the individual experiences loss of height in the vertebra. During vertebroplasty, a compound is injected with a needle into the compressed bone to try to stabilize the bone and improve pain. This hardens and stabilizes the fracture or collapsed vertebrae.

Vertebroplasty is generally performed at the hospital or on an outpatient basis. Many patients are discharged the same day or kept overnight for observation. Most patients experience significant pain relief within 24 hours.

Surgery is recommended if there is instability in the spine or specific findings on the neurologic exam that also show up in MRI or CT scans.

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