Osteoporosis
What is Osteoporosis?
Our bones are constantly undergoing a process of rejuvenation, known as bone remodeling. Bone remodeling allows for the resorption of old or damaged bone and the regeneration of healthy bone. If an imbalance occurs in the rate of bone loss to bone reformation, then osteoporosis can develop.
Osteoporosis occurs when the calcium-rich tissue that composes our bones loses its bone mineral density (BMD), becoming brittle and prone to vertebral compression fractures.
Our bones are naturally porous. Without sufficient calcium content to produce hydroxyapatite—the primary component of bone tissue—the honeycomb-like pores in our bones become wider and wider. Over time, our bones can become so porous that they can no longer support our weight effectively or fracture under the slightest application of pressure. For individuals with osteoporosis, everyday actions such as stooping or lifting—even coughing or sneezing—can instantaneously fracture bones.
Historically, osteoporosis has been more common in women than in men for several biological reasons. Women typically have smaller skeletal frames than men, so hastened bone loss is felt more acutely in women. The hormonal dips associated with menopause can also accelerate the loss of calcium from bone tissue.
As such, osteoporosis is categorized into two types. Type I Osteoporosis primarily affects women who have recently undergone menopause. A sharp decline in the production of estrogen speeds up the loss of trabecular, or spongy, bone matter. This type of osteoporosis usually emerges between the ages of 50 and 70-years-old and affects the structural integrity of the wrists, hips, joints, and spine.
Type II Osteoporosis typically appears after the age of 70 and reflects the culmination of life-long bone loss. Humans attain peak bone mass around age 30. Every year thereafter, we lose slightly more bone mass than our bodies can regenerate. Unlike Type I Osteoporosis, Type II Osteoporosis affects both men and women, reducing the amount of trabecular (spongy) and cortical (hard) bone tissue. Common fractures from Type II Osteoporosis are sustained in the hips and spinal vertebrae.
Concerned that you might have osteoporosis or the warning signs of osteopenia (the precursor for accelerated bone loss)? Dr. Frazier of NYC Spine specializes in vertebral augmentation procedures to repair shattered vertebrae from osteoporotic fractures.
What are the Symptoms of Osteoporosis?
Unfortunately, the warning signs of osteoporosis are especially subtle. Until the bones become fragile enough to break, an individual with osteoporosis may appear to be asymptomatic. Without the presence of symptoms, the best way to determine if you have osteoporosis is by undergoing a bone mineral density test. However, some individuals with osteoporosis may exhibit the following warning signs:
- Fractures: Brittle bones that easily fracture are the hallmark of osteoporosis. If you suffer from a mild fall or a minor blow (e.g. colliding with a piece of furniture) and it results in a broken bone, then you should be assessed for osteoporosis.
- Vitamin D Deficiency: Vitamin D is essential to enabling calcium absorption from our digestive tract. Without a sufficient supply of Vitamin D, bone remodeling cannot occur efficiently and bone loss is the ultimate result.
- Back or Joint Pain: Fragile bones are easily inflamed and can aggravate the tissues (such as muscles and ligaments) that support them. The lower back and joints are often the first regions of the body to be affected by osteoporotic pain, which can easily be misdiagnosed as arthritis.
- Loss of Height or Posture: A healthy spine will lose 1-3 inches of height over a lifetime, starting around middle age (or at approximately 45-years-old). Osteoporosis can accelerate this loss, such that an individual may lose several inches of height over a single decade or across the span of only a few years. As the spine begins to sustain more frequent fractures, the spinal curvature will also change. Kyphosis—which refers to an abnormal forward hunching in the thoracic spine, or middle back—may develop, permanently disrupting posture.
- Brittle Fingernails or Receding Gums: Calcium is also needed to maintain optimal dental health and strong fingernails. A deficiency in calcium will cause nails to chip off or break easily, and can result in receding gums or bone loss in the jaw.
Do you have a family history of osteoporosis or have you recently suffered from an age-related fracture? Dr. Daveed Frazier of NYC Spine has been redefining relief from osteoporosis through minimally invasive interventions for over 20 years!
What are the Treatments for Osteoporosis?
If you have been diagnosed with osteoporosis, your doctor will prescribe a combination of nutritional modifications, dietary supplements (including Vitamin D and calcium), and osteoporosis medications that promote bone growth and decelerate bone loss. Your primary physician will also recommend a regimen of weight-bearing exercises that will strengthen your muscles and bones and reduce your incidence of falls.
However, if you have suffered from a vertebral compression fracture (aka a shattered vertebra), your condition may require surgery to restore the structural integrity of your spine. Common surgical interventions for vertebral compression fractures may include:
- Kyphoplasty: During this minimally invasive procedure, your surgeon will use a balloon to restore the height of a collapsed or shattered vertebra. Once the balloon is inserted into the vertebral body, your surgeon will inject a fast-drying medical cement to maintain the height of this newly created space. Since this procedure does not involve the use of an incision, the strong muscles of your neck and back are preserved, greatly reducing your surgical recovery time.
- Vertebroplasty: A vertebroplasty is very similar to a kyphoplasty, except that the use of the balloon to restore vertebral height is omitted. Using needle entry instead of incision, your surgeon will inject a medical-grade cement into the damaged vertebra and use bandages instead of sutures to complete the procedure.
- Spinal Fusion (ACDF, ALIF, or XLIF): If your osteoporosis-related injury involves more than one vertebral fracture, then your doctor may suggest a spinal fusion procedure to reinforce the structural stability of your spine. During this set of procedures, your surgeon will repair the collapsed vertebrae and then use a bone graft to fuse together adjacent vertebral segments. Spinal fusion is often recommended to prevent the incidence of future fractures, when the spine is deemed to be especially weak.
Researching options for osteoporosis treatment and need to find a qualified physician who is trained in minimally invasive surgery? Dr. Frazier, twice honored by the New York Times Magazine as a “New York Super Doctor,” has earned over 20 years of experience in resolving vertebral compression fractures!
Meet Dr. Daveed Frazier
Dr. Frazier is a Harvard-trained, board certified orthopedic spine surgeon. He’s held an academic appointment at Columbia University College of Physicians and Surgeons and New York’s SUNY Downstate. Dr. Frazier is also a respected lecturer, accomplished researcher, published author on spine disorders and treatment, and a consultant for several international spine companies.
After completing his undergraduate education at Brown University, Dr. Frazier attended Harvard Medical School, where he graduated cum laude. He completed a Harvard internship based at the New England Deaconess Hospital in Boston, MA, followed by a Harvard combined residency before becoming chief resident at Massachusetts General Hospital.