Spinal osteoporosis fractures

One in four postmenopausal women have osteoporosis. Osteoporosis, a decrease in bone mass, constitutes the most serious effect of menopause. It has been estimated that following cessation of ovarian function, the loss of bone mass proceeds at a rate of 2 to 5% per year. As a result of osteoporosis, as many as 50% of women develop spinal compression fractures by age 75, and 20% will have hip fractures by age 90. 

Diamond TH, Bucci J, Kersley JH, Aslan P, Lynch WB, Bryant C. Osteoporosis and spinal fractures in men with prostate cancer risk factors and effects of androgen deprivation therapy. J Urol 2004 172 529-32. 

In adults receiving long-term parenteral nutrition, despite its anabolic effects on other tissues, there is no improvement in bone density. Infants treated with parenteral nutrition from birth also develop low bone density for age, suggesting that parenteral nutrition treatment in some way contributes to the osteopenia (5). A 17% long-term increase in spinal bone mineral content has been shown in patients who have received parenteral nutrition solntions without vitamin D. However, this rise was nearly balanced by a 15% fall in hip bone mineral content (115). In a Danish study of bone mineral content in adults receiving home parenteral nutrition for short bowel syndrome, despite the fact that all were on free oral intake as a supplement to the parenteral nutrition, 47% had mandibular osteoporosis while 33% had osteoporosis in the forearm and radiographic changes of osteoporotic fractures in the vertebral column. Dental and periodontal tissues were normal (116). 

Musculoskeletal Field concerned with the muscles and the bones of the body. Studies in this area include aging, bone density, bone fractures, chronic back pain, hip replacement, osteoarthritis, osteoporosis, rheumatoid arthritis, spinal cord injuries, and others. 

Fractures of the spine, wrist, and hips decrease by 50 to 70%, and spinal bone density increases by 5% (24), in those women treated with estrogen within 3 years of the onset of menopause and for 5 to 1 0 years thereafter (5,11,25). The minimum dose required and that which is considered to be standard therapy is 0.625 mg/day of conjugated estrogens (Premarin) however, a 0.3 mg/day dose of esterified estrogen (Estratab) has been shown to be adequate for the prevention of osteoporosis (5). Estrogen replacement therapy is available in several types of formulations, including transdermal patches (Climera, Estraderm, Menostar, or Vivelle). 

Generally, vertebral compression fractures are a consequence of osteoporosis, a disease characterized by a decrease in bone mass and a micro-architectural weakening of bone tissue. Considering that vertebral column is a complex structure whose aim is to provide mobility, flexibility and support to the upper part of the human body along with protection to the spinal cord maintaining as well as restoring it to its natural shape is essential. In particular, the vertebral body bears up to 20% of the compressive force supported by the human body [26]. Computed tomography scans of fractured... 

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