Osteoporosis is a medical condition in which the bones become thin and fragile. Because bone loss often occurs without any symptoms, osteoporosis is called the “silent thief”. Over 75% of people who have osteoporosis are unaware of it, and 90% of patients receive no treatment. A simple strain, twist of the body, bump, or fall can cause a bone fracture. Fractures can involve any bone, but one of the most common sites is in the vertebrae, the bones that make up the spinal column.
Over 10 million Americans suffer from osteoporosis, and another 44 million have thinning or osteopenia of the bones, which can lead to osteoporosis if untreated. 80% of those who are at risk and affected by osteoporosis are women. Of the over 1.5 million fractures each year caused by osteoporosis, almost half are spinal (vertebral) fractures.
Risk factors include: being female, advanced age, family history of osteoporosis, being postmenopausal, anorexia/bulimia, diet low in calcium, long-term use of steroids or anticonvulsants, lack of exercise, smoking, excessive use of alcohol.
Until recently, bed rest and pain medications were the only treatments available. If these fractures are left untreated, the patient often experience additional fractures, and develop a “hunched over” deformity of the spine (i.e kyphotic deformity or “dowager’s hump”). Today, there are minimally invasive treatments (ex. Vertebroplasty, ver-TEE-bro-plasty) which are safe and effective, with ~90% of patients reporting significant or complete pain reduction and return to baseline activity.
The patient lies on their stomach, and under sedation, a needle is directed under x-ray guidance into the fractured vertebral body. A special bone cement for medical use (PMMA) is injected in to the vertebrae to stabilize it. The procedure takes about an hour to perform. The pain relief can be immediate after the procedure, with the rest of the patients reporting this within 48 hours. It is also quite common for patients return to their baseline activity within the first or second day after the procedure.
People who have suffered recent fractures that are causing significant pain despite standard therapy (rest, pain medication) are the best candidates. Often the patients have focal tenderness of the spine at the level of the fracture. An MRI exam of the spine should show evidence of the acute/subacute nature of the fracture.