Osteoporosis
What is osteoporosis?
Osteoporosis is a condition characterized by a decrease in the density of bone, decreasing its strength and resulting in fragile bones. Osteoporosis literally leads to abnormally porous bone that is compressible, like a sponge. This disorder of the skeleton weakens the bone and results in frequent fractures (breaks) in the bones. Normal bone is composed of protein, collagen, and calcium all of which give bone its strength. Bones that are affected by osteoporosis can break (fracture) with relatively minor injury that normally would not cause a bone to fracture. The fracture can be either in the form of cracking (as in a hip fracture) or collapsing (as in a compression fracture of the vertebra of the spine). The spine, hips, ribs, and wrists are common areas of bone fractures from osteoporosis
What are the symptoms of osteoporosis?
Osteoporosis can be present without any symptoms for decades because osteoporosis doesn’t cause symptoms until bone fractures. Moreover, some osteoporotic fractures may escape detection for years when they do not cause symptoms. Therefore, patients may not be aware of their osteoporosis until they suffer a painful fracture. Fracture of the spine vertebra can cause severe back pain. Over the years, repeated spinal fractures and collapse can lead to chronic back pain with loss of height or curving of the spine. Once a person has experienced a spine fracture due to osteoporosis, he or she is at very high risk of suffering another such fracture in the near future (next few years). Women after menopause have more chances of fracture (as female require estrogen hormones for maintaining bone strength and this becomes less after menopause).
How to diagnose spine fracture collapse due to osteoporosis?
Patient (usually elderly) presenting with severe back pain (rarely neck pain if cervical spine is involved) esp on movements. To confirm X- ray and MRI usually required. MRI not only shows fracture collapse but also shows if any fracture piece has shifted near the spinal cord or dangerously pinching the spinal cord. This should be urgently brought in notice to a neurosurgeon inorder to avoid paralysis of the legs. But some unfortunate patients develop severe weakness or paralysis then come to neurosurgeon .
What is surgery for osteoporosis?
VERTEBROPLASTY: If MRI shows spine (vertebra) fracture but no cord compression (i.e., not associated with any weakness or numbness of arms and legs) – then a simple procedure like vertebroplasty can be performed for getting rid from local pain or endanger from further collapse and paralysis. This involves injection of bone cement in the spine bone and thus permanently strengthening it. It is very safe procedure and mostly gives unbelievably fabulous results. If there is weakness of legs due to spinal cord compression (pinch due to fracture piece) then a simple open surgery and releasing the pressure + followed by vertebroplasty (bone cementing) both at the same time, usually gives satisfactory outcome.