Osteoporotic Fractures

  • Osteoporosis is defined as a skeletal disease that causes the bones to become porous and less dense, which makes the bones vulnerable to fractures.
  • Osteoporotic fractures are sometimes called low-trauma fractures because they can occur with minimal force.
  • In fact, osteoporotic fractures of the spine can be caused by the normal force exerted on the vertebral column and not due to any trauma or unusual force at all.

Causes

  • Osteoporosis is a condition that affects millions of people around the world and diagnosed more often in women, affects both genders
  • The risk of developing osteoporosis increases with advancing age.
  • Incidence in the Middle East is very high due to the climatic conditions and more so due to cultural and religious aspects where the women have to be covered outside of their homes.

Terminology

  • Osteoporotic fractures are sometimes called fragility fractures, in that such fractures would not have occurred in an individual with strong, healthy bones.
  • The most common osteoporotic fractures are fractures of the vertebral column, ribs, hips, and wrist.
  • Osteoporosis is the result of an imbalance between the process of bone formationand bone reabsorption.
  • In the healthy individual, the body is constantly replacing old bone tissue in a balanced process (formationand reabsorption).
  • When these processes are out of balance, bone densitydecreases, bone architecture is disrupted, and bone strength is lost.

Symptoms

  • There are no specific symptoms of osteoporosis.
  • The main danger of osteoporosis is in increased risk of bone fractures.
  • If an osteoporotic fracture is suspected, the patient may be asked to undergo X-rays or submit to a bone mineral density test (BMD) to determine the presence of osteoporosis.

Treatment

The most important aspect of treating osteoporotic fractures is prevention of future fractures–if at all possible.

Osteoporotic fractures may be prevented by:

  • Lifestyle modifications to reduce or minimize osteoporosis
  • Intake of dietary supplements
  • Medications to improve bone density
  • Exercises to improve balance and strength (to prevent falls)
  • Assist devices, such as walkers, in certain individuals to reduce the risk of falls
  • Osteoporotic fractures are treated as a bone fracture, using bed rest, pain medications, and brace application to stabilize the break.
  • Osteoporotic compression fractures of the spine may be treated by a minimally invasive surgical procedure to help stabilize the fractured vertebrae and reduce the pain
  • These procedures are known as vertebroplasty and kyphoplasty (similar procedures with slightly different techniques).
  • In both vertebroplasty and kyphoplasty, bone cement is injected into the fracture to help stabilize and strengthen the bone.
  • Hip fracture patients are at risk for deep vein thromboembolism and should receive specific treatments to help prevent this potentially life-threatening condition.

Prognosis

  • Osteoporotic fractures are potentially serious conditions and are associated with pain and the possibility of complications.
  • For that reason, persons who have such a fragility fracture require expert medical attention as offered by the Neuro Spinal Hospital.
  • These fractures can be effectively treated but require specialized care that continues even after the fracture has healed.

Risk Factors

  • Osteoporosis is a common condition.
  • Risk factors include those that cannot be changed (non-modifiable) and those that are under a patient’s control (modifiable).
  • Among the non-modifiable risk factors are:
  • Female gender
  • Lower estrogen levels after menopause or surgery to remove the ovaries
  • European or Asian ancestry
  • Family history of osteoporosis (genetic factors)

Risk factors that may be at least under some degree of control by the patient include:

  • Alcohol and Tobacco usage.
  • Vitamin D deficiency
  • Poor nutrition, including unhealthful eating habits and high-protein diets
  • Being underweight
  • Sedentary lifestyle
  • Excessive physical activity (such as marathon running, competitive athletics)
  • Patients who have had one osteoporotic fracture are at high risk for having another and should consult with the Neuro Spinal Hospital Doctors to learn ways to minimize their risk of future fractures.

Conclusion

  • Osteoporotic fractures or fragility fractures are bone fractures that occur in patients with osteoporosis.
  • These fractures are associated with complications and pain.
  • Osteoporotic fractures of the spine, also called compression fractures, can be treated with vertebroplasty or kyphoplasty, minimally invasive surgical techniques where cement is injected into the fracture to stabilize the vertebra.
  • Other osteoporotic fractures are treated as conventional fractures, but osteoporosis patients with a fractured hip are at heightened risk for deep vein thromboembolism and require prophylactic therapy to help prevent this potentially dangerous condition.
  • Osteoporotic fractures are common but complex and deserve the expert attention and state-of-the-art treatments offered by the Neuro Spinal Hospital.