Diagnosing Osteoporosis and Treating Spinal Fractures

J. Michael James, MD

What is Osteoporosis?
Osteoporosis literally means “porous bones.” As we age the density and quality of our bones declines faster than new bone can form. As a result, our bones can become weak and prone to fractures. The typical affects of osteoporosis are gradual and without warning signs, until the disease is advanced. This is why osteoporosis is also known as the “silent disease.” Unfortunately, people usually don’t know they have it until it’s too late and have experienced a broken bone. Spine fractures (compression fractures) are the most common and can result in loss of height, severe back pain and curving of the back and shoulders.

Diagnosis and Testing
Early diagnosis, for those who have osteoporosis or are at risk, is the first step in their treatment and care. The most common way to have this done is with a bone mineral density (BMD) test. This is a painless and noninvasive scan which, depending on the technology, measures bone density in the spine, hip, wrist, hand, or heel. Dual Energy X-Ray Absorptiometry (DEXA) scan is the most commonly used method of measuring bone density. DEXA scan is a low radiation x-ray capable of detecting as little as two percent bone loss in the early stages of osteoporosis. A DEXA scan only takes a few minutes and is used to measure the bone density of the hip and spine.

There are a wide range of therapeutic options and several safe and effective medications that can reduce the risk of fractures. Ask your doctor to review your medications, including bone-related side effects. It is important that the choice of treatment be tailored to your specific medical needs and lifestyle.

Spinal Fractures
As mentioned earlier, spinal fractures (compression fractures) are the most common fracture associated with osteoporosis. A compression fracture is when one or more of the vertebrae (the bones that make up the spine) has collapsed or has been crushed. These fractures are typically caused by osteoporosis and in rare cases by cancers, benign tumors or trauma. In some cases, the fracture heals without treatment and the pain goes away. In others, the bone does not stabilize and continues to move, causing persistent pain. The pain and loss of movement severely limits activities and reduces quality of life, perhaps making compression fractures the most debilitating side effect of osteoporosis.

Treatment of Compression Fractures
Historically, patients with compression fractures were treated with strong pain medications, prolonged bed-rest, external bracing, or invasive spine surgery. These treatments are limited by long recovery times and a disruption of daily life. Vertebroplasty is a minimally-invasive, image-guided, outpatient procedure used to treat the pain associated with vertebral compression fractures. For most patients, vertebroplasty provides immediate and lasting relief of the pain related to vertebral compression fractures. Many patients return to their normal activities within only a few days of having the procedure, and most report continued relief from pain months and years later. In some cases, vertebroplasty can also prevent further collapse of the vertebrae, height loss and spine curvature. For additional information, contact The Alaska Spine Institute at (907) 563-8876 or visit www.alaskaSPINEinstitute.com