By Lawrence Greene, MD


Osteoporosis represents a significant global health problem. Once people pass age 50, one in every five men and one in two women sustain a fracture from osteoporosis at some point in life. Deaths related to the morbidity from osteoporotic fractures outnumber the sum of deaths from cancer of the cervix, ovaries, and uterus combined.

There are 2 times in life where osteoporosis formation has been shown to occur predominantly. The first is failure to achieve adequate bone mass during the most important time - adolescence. The other is during menopause or advancing age, which is where a high rate of bone loss occurs. Age is obviously uncontrollable, but there are contributing lifestyle choices like nutrition, smoking, medications (like steroids), and exercise which can mean a lot for bone density.

The definition of osteoporosis was established back in 1994 by the World Health Organization. Bone mineral density measurements are compared to what is known as "young normals" in the female population. If a person's bone mineral density falls within 1 to 2 standard deviations of these "young normal" the condition is referred to as osteopenia. If it is over 2.5 standard deviations below the norm, it is referred to as osteoporosis.

Based on the US 2000 Census results, over fifty million American individuals are diagnosed with either osteopenia or osteoporosis. Each year, over 1.5 million osteoporosis fractures occur in the US annually. Fifty percent of those happen in the spine, 20% at the hip, and thirty percent at the wrist. People in their fifties typically have wrist fractures. Once people reach their sixties, the spine is the most common anatomical area, and in the seventies the hip turns out to be the most common bone to fracture. Unbelievably, the death occurence after a hip fracture is twenty percent in the year after the fracture. Over 50% of male individuals with hip fractures do not get back their walking ability within one year after having a hip fracture, and sadly less than half ever get back their pre-fracture ability to perform activities of daily living such as grooming, eating, bathing, or dressing.

In spine fractures of the vertebra, occurence at multiple levels can produce a spinal curvature along with height loss. The rib cage may shift down and abut against the iliac crest. Organs can get compressed, and eventually a protuberance may become seen in the abdomen. Back pain, abdominal fullness, height loss, and inhibited breathing may be evident. The resulting kyphosis can lead to shallow respirations, which may make future anesthesia risky. Chronic lung disease may present itself.

Considering the substantial complications from hip and spine osteoporotic fractures, the best treatment method is actually to prevent their occurrence in the first place.




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