Osteoporosis – fractures in the spine

Osteoporosis is an insidious bone disease that affects almost half a million people in Switzerland alone. As you age, the bones in your body gradually break down. This is often referred to as “bone loss”. The bones become porous and prone to spontaneous fractures, which can also occur in the spinal column.

Symptoms

There are no typical signs of osteoporosis. The disease itself tends to go unnoticed until the first fractures occur. A spontaneous vertebral fracture usually causes dull back pain. To counteract the pain, you assume a relief posture and put stress on the back muscles in the wrong way. There may also be a noticeable decrease in the height of the affected individual, due to collapsing of the vertebral bodies.

Causes

A distinction is made between primary and secondary osteoporosis. The former is more common and is a consequence of age-related regenerative processes in the human body. It primarily affects women. Secondary osteoporosis is rare and coincides with other diseases and drug therapies (side effects).  

Primary osteoporosis is caused by a disruption in bone metabolism. As a result, more bone is broken down than is reconstructed. This can also be connected to hormonal changes, especially a lack of oestrogen, which is why the condition is especially common in post-menopausal women. Osteoporosis is also exacerbated by the following factors:

  • alcohol and nicotine consumption
  • drinking a lot of beverages that remove calcium from the body, such as tea and coffee
  • insufficient calcium intake (e.g. a vegan diet)
  • lack of exercise
  • extreme sports
  • vitamin D deficiency

Diagnosis

The presence and stage of osteoporosis are determined by means of a bone density measurement and recorded using a value known as the T-score. This is a reference value defined by the WHO, which evaluates bone density according to how it deviates from the bone density of a healthy 30-year-old. A value lower than -2.5 are indicative of osteoporosis. The procedure used to establish this value is called dual X-ray absorptiometry (DXA). In this examination, an X-ray is used to measure the content of mineral salts in the bones. DXA is performed on the lumbar spine and hip bone. X-rays are taken to diagnose any broken bones.

Treatment

Conservative therapy 

Unfortunately, osteoporosis cannot be cured. However, appropriate lifestyle choices and certain medications can slow the progression of the disease and relieve pain. During therapy, it is important to ensure a sufficient intake of vitamins and minerals, especially vitamin D and calcium. Other important factors include a balanced diet rich in calcium and protein, sufficient exercise and targeted strengthening exercises. Exercise promotes bone metabolism and strengthens the bones. Activities that do not involve an increased risk of falling, such as Nordic walking, as well as general walking and hiking, are ideal for preventing osteoporosis in old age.

Surgical treatment

Vertebral fractures are fixed by strengthening them with cement. The most common procedures are kyphoplasty and vertebroplasty, where bone cement is injected into the fractured vertebra through fine incisions in the skin of the back. After the operation, the patients can be mobilised immediately and bear weight on their back. The pain subsides quickly and it is possible to return to everyday life.

In the case of a severe vertebral fracture, which has also led to nerve constrictions or a curvature of the vertebral segment, open, surgical stabilisation is necessary. Then it may also be necessary to insert a place holder and straighten the crooked part of the spine using screws and rods.

FAQs

What foods should you avoid if you have osteoporosis?

Foods high in phosphate should be avoided. This mainly includes processed foods. You should also reduce your consumption of alcohol and drinks containing caffeine and theine, as these break down calcium rather than building it up.

What can I do to combat osteoporosis without medical treatment?

In order to prevent the progression of osteoporosis or avoid it altogether, a healthy lifestyle is important. These includes maintaining a calcium-rich diet, minimising your alcohol intake, refraining from smoking and getting plenty of exercise.

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