Thursday, February 14, 2019

Osteoporotic compression fracture threatens the spinal health of old age.

A compression fracture means broken bones by the external impact.
In the old age, osteoporosis weakens the bones and there is a high risk of compression fracture,
that’s why much care is necessary. If a compression fracture occurs in the spine and hip joint, it is easy to lose a normal life until you die because you are sick in bed.
Photo:Dr. Shih Min,Lee Neurosergeon of Wooridul Spine Hospital

A female, named  Ko 74 years old, started to feel  back pain suddenly after  field work from last autumn. She didn’t fall down or injured so that she was taking rest at home but her pain was getting worse and  worse every. After all she has visited me to appeal for severe radiating pain of left buttock.
After the X-ray examination I found that lumbar 2 was broken.
It is called ‘osteoporotic compression fracture.
Ko was revealed as a patient with osteoporosis who had been treated with injections every three months from three years before the accident.
According to the data from the National Health Insurance Corporation, 855,978 patients in Korea are receiving osteoporosis treatment as of 2016
Due to an aging society, average age of the population is getting higher and the number of osteoporosis patient is also increasing.
Osteoporosis is more common in women than men because of the hormone changes after menopause (estrogen deprivation) and occurrence of the rapid bone absorption.
Therefore, if you are older than 60 years, you should take a bone density test every 1-2 years to evaluate and prevent the risk of compression fracture. Taking calcium and vitamin D helps prevent osteoporosis.
There are calcium-rich foods such as milk, dairy products (cheese, yogurt, milk fermented beverages, etc.) and anchovies. The recommended daily dose of calcium is 800~1000mg, vitamin D is 800 IU.
In addition, regular exercise such as walking fast, proper aerobic exercise, stretching and strength exercise are beneficial for maintaining and strengthening bone density.
Due to cold weather like these days, there is a lack of activity and it is easy to lose momentum. It also depresses the immune system and muscle weakness to elderly people. Furthermore, it is vulnerable to trauma owing to the physical characteristics of elderly people. In many cases, the spine and hip joint bones are broken with compression fracture when they slip on ice, lift the heavy stuffs.
The average age of the patients undergoing surgery for these compression fractures was 70.53. And overwhelmingly 85.69% of them are women.
A total of 20,209 patients who underwent vertebral compression fracture diagnosis and had vertebroplasty at Chungdam Wooridul Hospital from 2000 to 2017 were analyzed.
This means that if you are aged and suffering from low back pain after falling or lifting a heavy object as in the previous example, Ko(f/74), it means that you should not hesitate to visit neurosurgeons or orthopedic specialists.
Anyone who is a specialist can easily detect a moderate compression fracture with a simple X-ray examination. Of course, a slight compression fracture that is not seen in X-ray imaging can be diagnosed by more precise examination such as MRI.
When osteoporotic compression fracture occurs it usually complains of back pain.
However, when the broken vertebral body is pushed backward,
it presses spinal nerve so that stimulates radiating pain of lower extremities, abnormal sensation, lower body paralysis due to muscle weakness.
The treatment is based on the medication therapy for osteoporosis, alongside with that medication treatment of a compression fracture & pain would be done preferentially.
Recently, there are many kinds of osteoporosis medications such as injections that are only injected twice a year, hormones that can be also used directly at home without visiting the hospital. It is convenient to consult with a specialist and choose your own suit.
Under doctor’s consultation you can choose your own treatment in your convenience.
Compression fracture problems are resolved by vertebroplasty if the pain does not diminish after 2 weeks of fixation and medication, or if the degree of injury is worse. Vertebroplasty is a method to fix a fractured site by injecting bone cement using a percutaneous medical syringe at the fracture area. It is one of the most widely used procedures because it is safe even in old age, rare complication, performed under local anesthesia. After the procedure, the patient is discharged the next day and go back to their routine quickly with speedy recovery.



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