January 2, 2024 Author : Maia Gonçalves In osteoporosis there is a decreased mineral density and deterioration of bone architecture. Bones become weaker and the risk of fracture increases . Fractures due to osteoporosis are pathological fractures called osteoporotic fractures . Osteoporosis is common: Mainly in women; With advancing age. This osteoporosis progresses without symptoms and is often diagnosed in tests performed when there is a suspicion or diagnosed fracture. However, in the last 10-15 years bone densitometry has become more common as part of regular health monitoring, especially in women after menopause . Its results together with health personal history, allow advice regarding measures (pharmacological and others) that can prevent/delay the progression of osteoporosis. Osteoporotic fractures of the spine The most common osteoporotic fractures of the spine are those that affect the vertebrae, especially the lumbar vertebrae. The prevalence of these fractures is 10%-24%. They can happen following a fall, but also with sudden movements or small physical efforts. In most cases, osteoporotic fractures of the lumbar vertebrae do not have neurological consequences. However, these may also occur, especially if there are already degenerative problems in the intervertebral discs. In this case, compression of the nerve roots in the lumbar area may cause pain (sciatica) and disability may be local or affect one or both legs. Symptoms of lumbar vertebrae fractures In around 66% of cases, osteoporotic fractures of the vertebrae do not cause symptoms. When there are symptoms, the main one is pain, which worsens with movement, particularly if this involves changing position, as well as coughing, sneezing or other actions that involve abdominal force. Diagnosis and treatment The diagnosis of an osteoporotic fracture of the vertebrae is based on the history and symptoms reported by the patient, medical examination, and imaging tests. Computed tomography (CT scan) and magnetic resonance imaging are the main ones. In addition to identifying fractures, they also allow them to be characterized and the associated neurological impairment assessed. Treatment of osteoporotic fractures of the vertebrae is non-surgical or surgical . The decision depends mainly on: Type and severity of the fracture; Neurological involvement; Age, general condition and wishes of the patient. Non-surgical treatment Non-surgical treatment involves simple actions and allows the resolution of many cases of osteoporotic fractures of the lumbar vertebrae within a few months : Rest; Analgesics when necessary to relieve pain; Use of orthoses, which are immobilization devices to help resolve the fracture. Surgical treatment The surgical techniques used to treat these fractures are minimally invasive . They do not involve large incisions and can be performed under general or local anesthesia: Kyphoplasty : through a needle placed in the fractured vertebra, a balloon is inserted which, after being inflated, increases the height and improves the shape of the body of the vertebra, forming a cavity where bone cement will be deposited for strengthening; Vertebroplasty : in this case the bone cement is deposited directly on the vertebra without the need for a balloon to create space. Prevention of osteoporotic fractures Prevention of osteoporotic fractures includes osteoporosis prevention measures and fall prevention measures. Prevention of osteoporosis throughout life is mainly carried out by: Maintaining a balanced diet with adequate levels of calcium and vitamin D; Practicing activity/exercise regularly. To prevent falls , especially in older people, special attention must be paid to: Wear correctly sized, properly adjusted and non-slip shoes. Ensure good lighting in walking areas; Eliminate obstacles in places where you walk, especially wires or small objects that are not easy to see.; Avoid slippery floors, for example carpets without a non-slip base, wet floors, among others; Ensure there are no vision problems and use appropriate correction when necessary. Meet the ortophedics clinical team from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
