Osteoporosis is called a "silent disease," because bone loss occurs without symptoms. People may not know they have osteoporosis until their bones become so weak that a simple strain, twist of the body, bump or fall causes a bone fracture. Fractures may occur in the hip, wrist, ribs or elsewhere, but the most common site of fracture is in the vertebrae, the bones that make up the spinal column.

There are 10 million people in the U.S. who suffer from osteoporosis and another 28 million with thinning bones that put them at risk for fractures. 80 percent of those affected are women. Also at risk are those whose bones have become fragile due to the long-term use of steroids to treat a variety of diseases such as lupus, asthma and rheumatoid arthritis. Significant risk has been reported in all ethnic groups, and while osteoporosis is most common in old age, it can occur at any time.

Among individuals with osteoporosis, there will be 700,000 painful spinal fractures each year. These so-called "compression" fractures are caused when the weakened vertebrae of the spine collapse — usually in the middle (thoracic) or lower (lumbar) spine. A collapsed vertebra may initially be felt as severe back pain. When more than one vertebra collapses, loss of height or spinal deformities such as kyphosis ("widow’s hump") or stooped posture may result. In some cases, the fracture stabilizes on its own, and the pain goes away. But for many, the pain persists because the crushed bone continues to move and break.

The Spinal Column. most fractures occur in the: Middle, or thoracic spine. Consists of 12 vertebrae, each carrying a set of ribs. or in the: Lower or lumbar spine. Consists of the five largest and strongest vertebrae.

 Risk Factors for Osteoporosis

Factors that increase the likelihood of developing osteoporosis include:

	Being female
	Advanced age
	A family history of osteoporosis
	Being past menopause
	Abnormal absence of menstrual periods
	Anorexia or bulimia
	A diet low in calcium
	Long-term use of medications such as corticosteroids or anticonvulsants
	Lack of exercise
	Smoking
	Excessive use of alcohol

Although there is no cure for osteoporosis, there are now several medications approved by the U.S. Food and Drug Administration that may prevent or treat osteoporosis. For women who have already experienced spinal fractures, however, there have been few effective treatments available until recently. Now, a safe, non-surgical, interventional radiology treatment called vertebroplasty offers new hope for women who suffer the pain of vertebral fractures.

  Vertebroplasty Treatments

Vertebroplasty was first performed in France in 1984 to treat compression fractures caused by bone cancer or bone metastasis, and later to treat compression fractures caused by osteoporosis. Percutaneous vertebroplasty was introduced in the United States in 1994 and has become widely available since 1997 as a treatment for pain associated with compression fractures due to osteoporosis. The procedure has been shown to provide continued pain relief for osteoporotic compression fractures. A 1998 study by Dr. Deramond and colleagues reported on 80 patients with rapid and complete pain relief in more than 90 percent of osteoporotic cases. The follow-up in this patient population ranged from one month to 10 years with evidence of prolonged pain relief. Vertebroplasty is likely to become a standard of care for treating osteoporotic compression fractures as more patients and physicians become aware of the new advances in interventional radiology.

Vertebroplasty is an outpatient procedure using X-ray imaging and conscious sedation. The interventional radiologist inserts a needle through a nick in the skin in the back, directing it under fluoroscopy (continuous, moving X-ray imaging) into the fractured vertebra. The physician then injects the medical-grade bone cement into the vertebra. Vertebroplasty takes from one to two hours to perform depending on how many bones are treated. The cement hardens within 15 minutes and stabilizes the fracture, like an internal cast.

In vertebroplasty, a needle about the width of a cocktail straw is inserted through the skin into the fractured bone. A bone cement is injected. The cement hardens, stabilizes the bone and prevents further collapse. This stops the pain caused by bone rubbing against bone.

  Recovery

Some patients experience immediate pain relief after vertebroplasty. Most report that their pain is gone or significantly better within 48 hours. Many people can resume their normal daily activities immediately.

Reprinted with permission of Sirweb.org