Bones that have become "brittle" cannot withstand the "weather and frost" - Let you understand osteoporotic vertebral compression fractures

Author: Han Liqiang, deputy chief physician of Tianjin Third Central Hospital

Reviewer: Guo Shuzhang, Chief Physician, Tianjin Third Central Hospital

Some elderly people will visit the orthopedic clinic due to low back pain. Some of them will have the following characteristics: they have not suffered obvious external injuries, but just feel as if they have twisted their waist; they do not feel pain when standing or walking, but when they sleep at night, as long as they turn over, they will feel obvious low back pain, and it is also more obvious when they get up in the morning; they have had low back pain for some time, and it seems that there is no big problem, but the pain is getting worse and worse.

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In these cases, doctors will recommend patients to undergo magnetic resonance imaging (MRI) because it is possible that there is an osteoporotic vertebral compression fracture. Fracture? How can there be a fracture when there is no external injury? In fact, the root cause of this fracture is osteoporosis.

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The name of the disease, osteoporotic vertebral compression fracture, is very long. In fact, it can be understood as a complication of osteoporosis. Everyone is familiar with osteoporosis. It is a common and frequently occurring disease among the elderly. It is characterized by decreased bone mass and destroyed bone microstructure, which leads to increased bone brittleness and increased risk of fractures. It is a metabolic bone disease. An obvious feature of osteoporosis is that it is usually not detected before the disease worsens because the change is subtle. Over time, bones will become as "crispy" as biscuits and will break with a slight touch. Even when sneezing or bending over to lift something, fractures may occur. Fracture sites usually include vertebral bodies, distal forearms, hips, proximal humeri, etc. Among them, vertebral fractures are the most common. Slight external forces can cause compression and deformation of the vertebral body. This is an osteoporotic vertebral compression fracture.

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Osteoporotic vertebral compression fractures are more common in elderly patients, especially women. They are prone to occur during daily activities and exercise. For some elderly people with severe osteoporosis, even holding a basin of water or sneezing can cause vertebral compression fractures. This type of fracture is more common in the thoracolumbar region. The main symptom is pain, and this pain is very characteristic: the pain will worsen when bending over, moving, coughing, and straining to defecate, but the pain will not be too obvious when sitting, standing, or even walking. It can be summed up in one sentence: "It doesn't hurt if the waist is not moving, but it hurts when it moves."

If you are diagnosed with osteoporotic vertebral compression fracture, you can take conservative treatment, which requires absolute bed rest and avoiding waist activities. You can also take analgesics as prescribed by the doctor. However, bed rest often takes 6 to 8 weeks, during which time you need to eat and defecate in bed. This makes many patients feel tormented, and it is also a great burden for their families.

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If you cannot stand lying in bed for a long time, or the pain is still severe after bed rest treatment, you can choose minimally invasive surgery - percutaneous vertebroplasty, which is currently the first-line treatment for osteoporotic vertebral compression fractures. The operation is to inject medical bone cement into the fractured vertebra through a percutaneous minimally invasive channel (no more than 4 mm in diameter) under the monitoring of the imaging system. This method can quickly relieve pain, enhance the strength of the fractured vertebra, and prevent further collapse and deformity of the vertebra. Because it is a minimally invasive interventional treatment, the operation time is short, local anesthesia is used, the incision is small, the amount of bleeding is small, and the analgesic effect is also obvious. For elderly patients, this minimally invasive surgery can greatly reduce the risk of surgery, avoid various complications caused by long-term bed rest (such as pressure sores, venous thrombosis, etc.), and the postoperative recovery is relatively fast. Generally, you can wear a brace to walk on the second day after surgery, and the hospitalization time will be shortened accordingly, which can effectively improve the quality of life of elderly patients.

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Of course, after an osteoporotic vertebral compression fracture occurs, in addition to treating the fracture, osteoporosis also needs to be treated, because the root cause of the fracture is osteoporosis, and "treating both the symptoms and the root cause" is the scientific treatment method.

There are many measures to treat osteoporosis, such as supplementing calcium and vitamin D, using anti-osteoporosis drugs, adjusting lifestyle (such as getting more sun exposure, quitting smoking and limiting alcohol, moderate exercise, etc.), etc.

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Osteoporosis is a chronic disease that is preventable and controllable. Only by adopting scientific prevention strategies can your bones withstand the test of time!