Approximately 700,000 vertebral, or spinal bone, fractures occur each year — usually in women over the age of 60. Researchers estimate that at least 25 percent of women and a somewhat smaller percentage of men over the age of 50 will suffer one or more spinal fractures. Younger people also suffer these fractures, particularly those whose bones have become fragile due to the long-term use of steroids or other drugs to treat a variety of diseases such as lupus, asthma and rheumatoid arthritis. Of particular concern are spinal fractures caused by a progressive weakening of the bone — a condition called osteoporosis. The pain and loss of movement that often accompany bone fractures of the spine are perhaps the most feared and debilitating side effects of osteoporosis. For many people with osteoporosis, a spinal fracture means severely limited activity, constant pain and a serious reduction in the quality of their lives.
Fractures of the vertebrae have traditionally been much more difficult to manage than broken bones in the hip, wrist or elsewhere. These broken bones can often be successfully treated with surgery. But because surgery on the spine is extremely difficult and risky, it has typically not been used to treat vertebral fractures associated with osteoporosis except as a last resort. Until recently, reduced activity and pain medications, many of which cause problematic side effects, or invasive (and often unsuccessful) back surgery were virtually the only treatments available. Today, however, there is a safe, non-treatment called vertebroplasty (ver-TEE-bro-plasty) that has been shown to be extremely surgical interventional radiology effective in reducing or eliminating the pain caused by spinal fractures.
Vertebroplasty Diagnosis About Osteoporosis and Spinal Fractures
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.
In the spinal column most fractures occur in the middle or lower spine. The middle or thoracic spine consists of 12 vertebrae, each carrying a set of ribs. 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
- 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.