If I’m taking a bisphosphonate medication, am I protected from having a spinal fracture? I see so many of my lady friends (we are all in our 80s) having these terrible compression fractures — one right after another. They are not taking Boniva like I am. After my first fracture, I started taking this drug and I’ve had no more problems. So I’m hoping it’s the medicine that’s helping me.

Every year, an estimated 44 million Americans will suffer back pain and disability from vertebral compression fractures (VCFs). This type of problem can do a lot of damage in terms of taking away a senior citizen’s independence. Finding a way to prevent (VCFs) is an important goal for many researchers.

The use of bisphosphonates is one way to target folks with low bone density (osteopenia or brittle bones(osteoporosis). Bisphosphonates are used to prevent bone fractures. They keep bone cells from being absorbed or destroyed.

Boniva (ibandronate sodium) and Fosamax, known to the pharmacist and doctor as alendronate are the most commonly prescribed bisphosphonates. Others include Actonel (risedronate), Aredia (pamidronate), and Zometa (zolendronate).

Your question is a good one: do bisphosphonates help prevent future vertebral compression fractures? Researchers are trying to find an answer. A recent study was done along these lines at a medical center where three surgeons performed kyphoplasties on 256 patients.

Two-thirds were women and the remaining one-third of the patients were men. Participants were divided into two groups based on age (over or under 75 years old). Data was also analyzed from the viewpoint of smoker vs. nonsmoker, bisphosphonate user vs. nonbisphosphonate user, and steroid user vs. nonsteroid user.

About one-fourth (22 per cent) of the entire group had a second vertebral compression fracture after the first was treated with kyphoplasty. All were treated conservatively (without kyphoplasty) at first.

Smoking and age did not seem to factor in to additional compression fractures. Bisphosphonates did not prevent future fractures (at least not in the short-run). And the single most important risk factor for second fractures was the chronic (long-term) use of steroid medications.

This study raised the question of whether bisphosphonates prevent additional vertebral compression fractures. In other words, does the patient benefit by taking them? Based on results of other studies, it’s possible that only long-term use (three years or more) of bisphosphonates makes a difference. But it’s something that should be investigated further.