osteoporosis is a deficiency of bone mineral density that increases fracture risk . because the number of elderly people in the population is currently increasing
the age - specific prevalence of osteoporosis is less than 2% in women younger than 50 years . between the ages of 20 and 40 years
our case provides a perspective on the diagnosis of postpartum osteoporosis and complications such as compression fracture .
one month earlier , she had a tertiary cesarean section and a left ovarian cystectomy . during the cesarean section , there were no other complications .
she had no past surgical or family histories , nor had trauma . on physical examination , she had diffuse back pain .
the pain was so severe that she had difficulty in getting up for 7 days .
the lumbar spine anteroposterior ( ap ) and lateral revealed recent compression fractures of t12 , l1 , and l3 .
a bone scan also revealed increased bone uptake , perfusion , and multiple recent compression fractures of t12-s1 ( fig .
bone marrow density determined using dual energy x - ray absorptiometry ( dxa ) revealed that the t - scores for the lumbar vertebrae l1-l4 , femoral neck , and femoral total were significantly low in the patient ( fig .
2 ) . she was given calcium 500 mg daily and a chest brace for non - weight bearing .
osteoporosis is a skeletal disease involving decreased density of the mineral portion of the bone .
the causes of osteoporosis are most commonly age , menopause , hormone imbalance involving the thyroid or parathyroid , and alcohol intake .
osteoporosis is diagnosed according to the 2007 international society for clinical densitometry ( iscd ) official positions or world health organization ( who ) criteria .
we previously differentiated the two criteria and revealed that the who criteria are more tolerant than the iscd official positions .
because osteoporosis is related to fractures , a fracture - risk assessment tool ( frax ) using clinical risk factors combined with femoral neck bone mineral density ( bmd ) can predict the 10-year fracture risk .
we previously reviewed the korean frax model with the general population and recommended that physicians use the korean frax model in the general female population to predict fracture risk .
we already found that serum ( 25-[oh]d3 ) concentrations were significantly correlated with age ( p=0.001 ) , duration of menopause ( p=0.005 ) , and osteoporosis ( p=0.044 ) .
also , erythrocyte levels of n-3 polyunsaturated fatty acid ( pufa ) and intake of fish were positively correlated with bmd of the femoral neck .
however , vitamin d and diet are not included as fracture risk factors . in our analysis of the bmd and previous obstetric history ,
another study also revealed that postmenopausal women had a correlation between risk factors for osteopenia or osteoporosis and obstetric history including previous gravity .
a possible mechanism of postpartum osteoporosis involves ligament laxity due to endocrine changes such as parathyroid hormone ( pth)-like peptide , magnesium sulfate management , prolonged bed rest for preterm labor , and stress or fatigue fractures during delivery .
the fetus takes 30 g of calcium from the mother , and hypoestrogenemia during breast - feeding leads to bone mineral loss in women . as the gestational age proceeds ,
because of their increased number of pregnancies , they have a longer duration of breast - feeding .
therefore , correlations between the severity of bmd and breast - feeding duration with osteoporosis are unclear .
the most common symptom is severe back pain in the lower thoracic , lumbar region .
the most common site in pregnancy- and lactation - associated osteoporosis is the vertebrae , as in our case .
in particular , more than 1 standard deviation ( sd ) of bone loss was found .
we should recognize the potential risk of postpartum osteoporosis and carefully differentiate back pain after delivery to prevent osteoporotic fractures .
 osteoporosis is mainly a problem in postmenopausal women . 
 however , we had a case of postpartum compression fracture associated with osteoporosis . 
 a 42-year - old multiparous woman had undergone tertiary cesarean section without complications 1 month before . 
 she was breast - feeding her baby and had no other bone - related complication history . 
 she did not exercise on a regular basis . 
 she experienced back pain abruptly and was diagnosed with a recent compression fracture of t12 , l1 , and l3 . 
 we evaluated this rare case of postpartum osteoporosis and compression fracture . 
INTRODUCTION
CASE
DISCUSSION