The World Health Organization has ranked osteoporosis as the second most important disease, after cardiovascular disease. Some call it the silent threat because it comes without warning. However, some signs may be noticed, such as a decrease in height compared to before, a stooped back, or symptoms like body aches similar to bone pain. It is a disease that requires attention because people with this condition often do not realize it… until they find out after a bone fracture has occurred, which usually happens in the wrist, hip, pelvis, or vertebral compression fractures.
“Vertebral Compression” Another Suffering from Osteoporosis
Osteoporosis causes vertebral compression fractures, which can result from various causes such as lack of exercise, insufficient calcium intake, vitamin D deficiency, alcohol consumption, drinking soda, smoking, postmenopausal women, hysterectomy and ovary removal, or certain medications such as chemotherapy drugs, blood thinners, steroid anti-inflammatory drugs. Additionally, having family members with certain diseases like hyperthyroidism or parathyroid disease can accelerate bone loss, leading to vertebral collapse or fractures even from minor falls or daily activities. This causes severe pain and suffering, making it impossible to live a normal life.
MRI is the Most Accurate Diagnostic Tool for the Spine
A common problem is that patients and their families often do not understand “Why is there back pain?” and why the pain is so severe and persistent even after taking medication or receiving injections. The best method.. to diagnose whether the vertebral compression fracture is truly due to this disease, or if it is a new fracture or an old one that has been present for many years, is to perform a magnetic resonance imaging (MRI) of the spine. This helps doctors plan the treatment more accurately and completely.
Treatment for Elderly Patients with Vertebral Fractures Can Be Done as Follows…
1. Treatment by wearing orthotic devices or back braces (ORTHOSIS) continuously
This is done continuously for 3-6 months depending on the severity of the fracture. The treatment is effective in patients who cooperate in wearing the support device and when the collapse or deformity is not severe. The correct way to wear it is before standing up, sitting, or walking. If the brace is worn after standing or sitting, the collapse will worsen due to the weight pressing on the fractured area, causing more stooping.
2. Surgery using metal implants to support the bone
This is used to correct the curvature of the spinal structure, and the metal helps support or reinforce the structure. Advantages: The surgeon can correct the abnormal curvature of the back to near normal and relieve the patient’s pain from the fracture because the metal supports the bone structure. Disadvantages: The patient must undergo surgery, the metal implants require many screws (at least 10-12), and general anesthesia is needed. Elderly patients have additional risks due to pre-existing conditions, so some may not prefer this method.
Cement Injection… A New Technique for Treating Vertebral Fractures Without Surgery
This involves injecting bone substitute material into the fractured area and porous spaces in the bone, especially in the spine. This method is interesting because it does not require surgery or general anesthesia. It uses local anesthesia combined with injectable sedation and takes only about 20-30 minutes. The medical cement used is recognized as safe for the body and does not cause rejection.
After treatment, only a 2-3 millimeter skin wound remains, which is the needle entry point to the fractured bone. Patients should stay in the hospital for observation for about one night. After the procedure, symptoms improve significantly. However, it is limited to patients over 60 years old and is not performed on younger individuals with vertebral fractures.
Nevertheless, if a fracture has occurred anywhere before, it is essential to prevent further fractures or fractures in other locations by ensuring patients consume a balanced diet with all five food groups, calcium supplements, vitamins, and bone-strengthening medications, exercise regularly, and avoid risk factors. Importantly, women aged 50 and above should have bone density tests to check bone thickness (Bone Density) (Figure 2) and have their blood vitamin D levels checked at least once. If normal, testing is recommended every 2-3 years, but if abnormal, treatment can begin early.
