Osteoporosis is a bone disease which causes a gradual decrease in bone mineral density. 80% of people affected by this condition are women. The micro-architecture of the bone system becomes brittle and compromised, which causes higher susceptibility to fractures even when experiencing everyday stresses like sneezing, vacuuming, or walking up stairs. The World Health Organization classifies osteoporosis as having bone mineral density 2.5 standard deviations below peak bone mass. The peak bone mass is determined by the average bone density of a 20 year old person of the same sex.

What Are The Symptoms Of Osteoporosis?

Women and men at risk for osteoporosis can experience no symptoms until their condition has become a serious health issue. It is important to pay attention to symptoms of decreased bone density, pains in joints and back, a loss of height over time, or consistent multiple fractures in the hands, wrist, and spine. These are all telltale signs of the onset of osteoporosis.

What Causes Osteoporosis?

A low intake of calcium, phosphorus, and other minerals important for bone growth and renewal can cause your bones to lose their internal structures. These structures are important for maintaining bone mineral density and prevent fractures.

Our bone structure is constantly regenerating itself. During childhood and early adulthood your bones are replaced with larger bone mass then before. A peak bone mass is reached around age 30. After peak bone mass is reached your body produces slightly less bone mass the previous cycle. This leads to a decreased amount of bone mineral density decades later.

The complications of osteoporosis can range from minor to severe. Bones that directly support your body’s weight, such at the hip and spine, are most commonly affected. These injuries usually come from falling. Wrist fractures are also a big risk. A severe fracture can occur without physical trauma. In some cases the bones of the vertebrae can become so brittle they simply fracture under pressure. This is known as compression. Compression can be a very painful condition and causes gradual loss of height

Who Is Likely To Get Osteoporosis?

It was once common belief that only postmenopausal women suffered from osteoporosis. Osteoporosis can affect anyone without regard to gender, age or ethnicity. Statistically, women 50 and older are most likely to acquire this condition. However, 20 percent of those with osteoporosis are men.

What Does Treatment For Osteoporosis Involve?

Preventative measures against osteoporosis are:

• Regular exercise
• Avoid smoking
• Include soy products to your diet
• Limit caffeine
• Avoid excessive alcohol
• Adequate calcium intake
• Adequate vitamin D intake, which assists the absorption of calcium consumption

If you are currently living with osteoporosis it is very important to continue following these preventative measures in order to counteract a progressive loss of mineral density in your bones.

It is recommended that premenopausal and postmenopausal women taking hormone therapy should consume at least 1200 milligrams of calcium and 400 IU (international units) of vitamin D daily. All people susceptible to developing osteoporosis should consume at least 1500 milligrams of calcium and 800 IU of vitamin D every day.

Prescription drugs are another route to treat osteoporosis. The drugs listed below will help to preserve bone density and mass, and some can even improve the density of your wrists, spine, and hip, which are most prone to fracture.

• Bisphosphonates – This class of drugs is similar to estrogen in that it prevents bone resorption and can prevent the breakdown of bone mass. It can also increase bone density in key areas like the spine and hip. This reduces the risk of fractures. Typical bisphosphonates used in treatment of osteoporosis include alendronate (Fosamax) and risedronate (Actonel).

Bisphosphonates do have side effects including nausea, stomach pains, and the risk of an inflamed esophagus or esophageal ulcers if tablets are not swallowed properly with plenty of water.

This drug can be taken orally once a week or once a month. If you find oral biphosphonates intolerable your doctor may recommend scheduled IV infusions.

• Raloxifene – This drug is a type of SERM (selective estrogen receptor modulator); it mimics estrogen, which is beneficial to sustaining bone density without the risk of uterine or breast cancer that is usually associated with estrogen-based hormonal therapies.

• Calcitonin – Calcitonin is a peptide hormone that is critical in the metabolism of calcium and phosphorus. It inhibits bone resorption, increases calcium in the bones, and decreases calcium levels in the blood.

Surgery

Vertebroplasty and kyphoplasty are two procedures that help to mend spinal fractures caused by osteoporosis by cementing the bones.

Vertebroplasty

Vertebroplasty is a minimally invasive procedure that is designed to relieve the pain of compression fractures. Vertebroplasty involves fixing the vertebral body. In addition to relieving pain, those vertebral bodies that are weakened but not yet fractured can be strengthened, thus preventing future problems.

How is Vertebroplasty performed?

Under general anesthesia, a special bone needle is passed slowly through the soft tissues of the back. Image guided x-ray, along with a small amount of x-ray dye, allows the position of the needle to be seen at all times. A small amount of orthopedic cement, called polymethylmethacrylate (PMMA), is pushed through the needle into the vertebral body. PMMA is a medical grade substance that has been used for many years in a variety of orthopedic procedures. The cement is mixed with an antibiotic to reduce the risk of infection, and a powder containing barium or tantalum, which allows it to be seen on the X-ray. When the cement is injected it is like a thick paste, but hardens rapidly. Usually each vertebral body is injected on both the right and left sides, just off the midline of the back.

Kyphoplasty

Kyphoplasty is a newer treatment for patients immobilized by the painful vertebral body compression fractures associated with osteoporosis. Like vertebroplasty, kyphoplasty is a minimally invasive procedure that can alleviate up to 90 percent of the pain caused by compression fractures. In addition to relieving pain, kyphoplasty can also stabilize the fracture, restore height and reduce deformity.

Kyphoplasty is performed under local or general anesthesia. Using image guidance x-rays, two small incisions are made and a probe is placed into the vertebral space where the fracture is located. The bone is drilled and a balloon, called a bone tamp, is inserted on each side. These balloons are then inflated with contrast medium (to be seen using image guidance x-rays) until they expand to the desired height and removed. The spaces created by the balloons are then filled with PMMA, the same orthopedic cement used in vertebroplasty, binding the fracture. The cement hardens quickly, providing strength and stability to the vertebra, restoring height and relieving pain.

What Are The Advantages Of Surgical Treatment?

These procedures provide new options for compression fractures and are designed to relieve pain, reduce and stabilize fractures, reduce spinal deformity and stop the “downward spiral” of untreated osteoporosis.

Additional benefits of these procedures include:
- Only general or local anesthesia required
- Patients can quickly return to the normal activities of daily living
- No bracing is required

Both vertebroplasty and kyphoplasty utilize a cement-like material that is injected directly into the fractured bone. This stabilizes the fracture and provides immediate pain relief in many cases. Kyphoplasty has the additional advantage of being able to restore height to the spine thus reducing deformity. After either procedure, most patients quickly return to their normal daily activities.

(Source: SpineUniverse.com)

How Long Does It Take?

Vertebroplasty and kyphoplasty generally take about 2 hours.

How Many Treatments Are Required?

Usually one treatment obtains the desired result

Will I Have Pain?

The procedure should relieve the pain. There may be a small amount of pain post-procedure, but this is easily managed with over-the-counter or prescription pain medication.

When Can I Go Back To Work Or School?

Many patients go back to work within a few days to a week.

Who Will Perform My Treatment?

All treatments are performed by our expert orthopedic surgeons.

What Are My Alternatives to Surgery

Medication – see above

How Much Does Osteoporosis Treatment Cost?

The cost for treatment may vary from patient to patient depending on various factors.

Discounts for multiple procedures are available.

For Further Information

Call TopSurgeons at 800-506-8084 and arrange a private consultation. We can answer any questions you might have about osteoporosis or anything else!