Surgeons from The Boston Spine Group and Thomas Jefferson University reviewed 200 articles on the treatment of osteoporosis in the spine. In this review, they share their findings on risk factors and current research on this topic. Treatment with and without surgery is presented.
The number of men and women affected by osteoporosis continues to rise in the U.S. Age is the biggest risk factor for both genders. Menopause is a major risk factor for women. Anyone who has had an osteoporotic vertebral compression fracture (OVCF) is at five-times the risk of having another.
Prevention is advised and is most cost-effective. When OVCFs occur, treatment is usually nonsurgical. Some people have no symptoms of OVCF at all. Most patients have back pain for six to eight weeks. Bed rest should be limited to no more than one to three days. Pain relievers, bracing, and movement are the main management options.
Surgery may be needed for those patients whose pain and disability persist. There are several surgical options. These include vertebroplasty and balloon tamp reduction (also known as kyphoplasty).
Both vertebroplasty and kyphoplasty inject cement into the vertebral body. Pain relief and improved function are common results from this treatment. Other surgical treatments considered include spinal cord decompression and instrumentation with hooks or screws to hold the bones together.
Studies show surgical treatment of the osteoporotic spine is problematic. Choosing the right patients for each surgical option is the key to a good result. In the future, new materials and medications may be available to improve bone density and strength and more effectively prevent OVCFs.