Osteoporosis
Osteoporosis – Osteopenia
What it is
Osteoporosis is characterized by many as an insidious disease, without the appearance of symptoms in the early stages. Its diagnosis, when no preventive screening is performed, is usually made when it has developed into an advanced form with bone fractures.
Osteoporosis: Types & Symptoms
1.
Primary and secondary osteoporosis
Primary osteoporosis includes postmenopausal osteoporosis and premature menopause, senile osteoporosis and idiopathic osteoporosis.
Secondary osteoporosis develops as a consequence of a pre-existing disease (hyperthyroidism, rheumatoid arthritis) or from prolonged immobilization of the patient. It can also occur after chronic use of certain medications (cortisone).
2.
Uncontrollable risk factors that cause osteoporosis
Gender, age, menopause and family history play a very important role in primary osteoporosis. In secondary osteoporosis, it is necessary to first treat the disease from which the osteoporosis originated and then to receive treatment if necessary.
3.
Risk factors controlled by the patient
These factors are mainly related to lifestyle. For example, caffeine, smoking, alcohol, insufficient calcium intake, lack of exercise, vitamin D deficiency, contribute to the onset of the disease.
4.
Medical assessment and diagnosis of osteoporosis
- Taking a complete history
- Clinical examination
- Bone density measurement
- Laboratory tests
5.
Bone density measurement
It is the only reliable test that offers a diagnosis of osteoporosis, even before the fracture occurs. It is very helpful in assessing the risk that someone has for a future fracture.
6.
FRAX index
If the bone density measurement is low, then the FRAX index can highlight the possibility of a fracture. This way the doctor has a better idea of whether you should receive medication or not. FRAX is useful in women and men over 50 years of age, in patients with osteopenia, but also in patients who have never taken medication for osteoporosis.
Additional tests that may be useful are X-rays, CT scans and MRIs that highlight the bones and other anatomical elements of the spine in every detail.
Osteoporosis treatment & bone mass restoration
Treatment for osteoporosis includes a combination of treatments such as taking calcium and vitamin D or other drugs that stop the progression or even reverse osteoporosis. The treatment is individualized each time depending on the specifics.
Surgical treatment
When there are osteoporotic vertebral fractures that do not heal in the expected time, then the treatment of osteoporosis is surgical with great success. The methods chosen are mainly vertebroplasty – kyphoplasty, and secondarily the correction of complex adult deformities and minimally invasive spinal fusion.
The aim of the surgical procedure is to limit pain and reshape the vertebrae, in order to minimize the possibility of fractures to a minimum. Of course, the pharmacological treatment of osteoporosis is paramount.
Vertebroplasty – Kyphoplasty
Vertebroplasty is a method that stabilizes the fracture that has been created by injecting a special cement. Kyphoplasty is exactly the same method with some additional elements. Specifically, before the cement is injected, a special balloon is inserted into the fracture, which inflates and lifts the roof of the vertebra, simultaneously forming a cavity which is then filled with the special cement.
Correction of complex adult deformities
When there is a large deformation in the spine that is also due to osteoporosis, then surgical correction of the post-traumatic kyphosis of the spine and its stabilization is chosen, after first treating osteoporosis with medication.
Minimally invasive spinal fusion
With this technique, spinal fusion is achieved with smaller incisions above each vertebra. The operation is performed with the minimum possible iatrogenic injury to the paraspinal muscles. The total operation time does not exceed two hours and hospitalization does not need to be longer than 1 day.
Frequently Asked Questions about Osteoporosis
Does osteoporosis also affect men?
Senile osteoporosis, which only occurs in old age, can also affect men. It can often be due to alcoholism. Sometimes, it is also related to other pathological problems such as hypogonadism.
How can osteoporosis be diagnosed before a fracture occurs?
Women who enter menopause should consult their doctor in order to properly evaluate any signs of bone thinning.
