Osteoporosis: Causes, Symptoms, and Treatments

Osteoporosis is a weakening of bones due to less calcium inside the bones. It actually affects bone mineral density and quality which leads to an increased risk of fractures. It causes bones to become brittle — so that even a mild stress or any trivial injury like bending forward or coughing or sudden jerk while traveling a fall will lead to fracture in spine called compression wedge fracture vertebrae. 

Hip, Wrist, and Spine fractures are the most common types caused by osteoporosis.

Most common causes of Osteoporosis are – 

• Calcium deficiency: 

Low calcium levels lead to decreased bone density, early bone loss, and increased fracture risk.

• Vitamin D deficiency. 
• Hormonal Imbalances

Osteoporosis is accelerated by low estrogen levels in women and low testosterone levels in men. It is very common in middle aged and old age women due to hormonal imbalances after menopause.

Sedentary lifestyle and Excessive alcohol consumption and Tobacco use. 

• Steroids intake

Long-term use of oral or injected steroid medications interferes with the bone-rebuilding process.

• Medical conditions

Those with specific medical conditions such as multiple myeloma, rheumatoid arthritis, cancer, inflammatory bowel disease, kidney or liver disease, and celiac disease have a higher risk of developing osteoporosis

• Surgery done in past

Surgery like hysterectomy done in females in the past are higher risk of developing osteoporosis.

• Generalized body pain and weakness 
• Back pain due to fracture in spine
• Loss of height over time and A stooped posture

• Blood test includes blood Calcium level , vitamin D level and hormonal level in blood. 
• Bone mineral density (BMD) Dexa scan tests are also known as dual-energy X-ray absorptiometry (DEXA or DXA) scans. These x-rays use very low levels of radiation to assess bone density in the wrists, hips, and spine.

• Above is a case of 65 yr female patient having L1 osteoporotic compression fracture
• Surgery – L1 balloon kyphoplasty under LA

Conservative treatment with medical management

It includes exercise, lifestyle modifications, calcium, vitamin and mineral supplements and a high protein diet with some anti-osteoporotic medications.

Medicines  include bisphosphonates, calcitonin nasal spray, estrogen agonists, or antagonists or injection teriparatide hormone. And Injection Denosumab 

Injection Teriparatide dose is 20 microgram daily sc for 1 year and injection denosumab dose is 60 microgram sc once every 6 months for 3 year (called Dual Therapy) 

Dr. Sanyam Jain is the Best Spine Surgeon in Delhi NCR is recommended for surgery to the patients who have back pain or weakness in legs and inability to walk and inability to do daily activities. 

The common surgeries performed under local anesthesia are Percutaneous Vertebroplasty and Kyphoplasty. These are minimally invasive procedures that use needles to inject bone cement into the fracture vertebrae. These surgeries are recommended in compression wedge fracture with no neurological deficit in legs.

Spinal fixation stabilization and decompression with or with our cementing is usually recommended in patients with fracture with cord compression.