Within the framework of micronutrient medicine (vital substances), the following vital substances (macro- and micronutrients) are used for prevention and supportive therapy: Calcium is an essential component of bones. Therefore, it is essential to ensure a calcium-rich diet. In addition, calcium supplements can be used. In order for the body to properly absorb and utilize … Osteoporosis of the Spine: Micronutrient Therapy
Surgical measures Frequently, after fractures (broken bones), surgical therapy must be performed to restore the stability of the bone. This mainly concerns fractures of the hip and thigh. For fractures of the vertebral bodies, the type of therapy depends on whether the fracture is stable or unstable. More than 33% of vertebral body fractures lead … Osteoporosis of the Spine: Surgical Therapy
Before puberty, the skeletal system develops predominantly without the influence of sex hormones, with bone growth controlled by genetic predisposition responsible for 60-80% of bone mass and fracture resistance (“bone fracture resistance”), the calcium–vitamin D system, and physical stress. The situation changes with the onset of puberty. During puberty, the skeletal system becomes sex hormone … Osteoporosis of the Spine: Physiology
The following are the most important diseases or complications that may be contributed to by osteoporosis of the spine: Respiratory system (J00-J99) Limitation of lung function due to fractures (broken bones) in the thoracic spine. Cardiovascular system (I00-I99) Limitation of cardiac function due to fractures in the thoracic spine. Heart failure (cardiac insufficiency) Coronary artery … Osteoporosis of the Spine: Complications
Densitometric classification of osteoporosis (WHO staging). Grade Classification T-Score Normal ≥ – 1 + no fractures (broken bones) 0 Osteopenia (reduction of bone density) – 1.0 to – 2.5 + no fractures 1 Osteoporosis ≤ – 2.5 + no fractures 2 Manifest osteoporosis ≤ – 2.5 + 1-3 osteoporosis-related fractures (broken bones). 3 Advanced osteoporosis … Osteoporosis of the Spine: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height [reduction in height]; further: Inspection (viewing). Skin (normal: intact; abrasions/wounds, redness, hematomas (bruises), scars) and mucous membranes. Gait pattern (fluid, limping) [gait insecurity due to faulty statics and shift in center of … Osteoporosis of the Spine: Examination
Laboratory parameters of the 1st order – obligatory laboratory tests (unless otherwise shown). Blood tests Blood count ESR (erythrocyte sedimentation rate) or CRP (C-reactive protein). Serum calcium Serum phosphate Serum creatinine, creatinine clearance if applicable. Alkaline phosphatase (AP) Gamma-GT TSH (thyroid-stimulating hormone) Serum electrophoresis If necessary, hydroxy vitamin D3 (as a case-by-case decision). Testosterone in … Osteoporosis of the Spine: Test and Diagnosis
Therapeutic target Avoidance of complications and further progression of bone destruction. Therapy recommendations Therapy scheme (applicable to DXA values only). Age in years T-score (applicable to Dexa values only. The efficacy of pharmacotherapy has not been proven with certainty for peripheral fractures (broken bones) with a T-score > -2.0) Ms Man -2,0 – -2,5 -2,5 … Osteoporosis of the Spine: Drug Therapy
Obligatory medical device diagnostics. Osteodensitometry (bone densitometry) – for early diagnosis of osteoporosis and follow-up of therapy, bone density can be determined as follows: Dual-X-ray absorptiometry (DXA, DEXA; dual X-ray absorptiometry; method of first choice)Note: DXA images are not informative in scoliosis. In scoliosis patients, bone density should be measured only at the hip. Quantitative … Osteoporosis of the Spine: Diagnostic Tests
Main risk for the occurrence of osteoporotic fractures is: Age > 70 years BMI < 20 kg/m2 Positive fracture history: Fracture after inadequate trauma. Femoral neck fracture in 1st degree relatives. A balanced lifestyle can maintain bone mass longer before the resorption/formation ratio is shifted in favor of resorption and slowly bone mass is lost. … Osteoporosis of the Spine: Prevention
Osteoporosis does not cause pain. Only when fractures* (broken bones) have occurred can the following symptoms occur: Pain – osteoporotic fracture pain is severe and lasts for approximately four to six weeks, until the fracture is consolidated (longer if the fractures do not heal). Typically, there is a concussion sensitivity of the spine (head sensitivity) … Osteoporosis of the Spine: Symptoms, Complaints, Signs
Pathogenesis (disease development) The maximum bone mass (peak bone mass) is reached in the 30th to 35th year of life and is 60-80% genetically predetermined. In normal bone metabolism, there is a steady balance between bone resorption and bone formation. This balance is maintained until about the age of 40. After that, the body loses … Osteoporosis of the Spine: Causes
