![]() ![]() The US Preventive Services Task Force (USPSTF) recommends screening for osteoporosis in women aged 65 years or older, and in younger women whose fracture risk is equal to or greater than that of a 65-year-old white woman who has no additional risk factors. Although osteoporotic spinal compression fractures do not generally cause neurologic problems, the presence of neurologic signs indicates a need for urgent computed tomography (CT) or magnetic resonance imaging (MRI). ![]() Neurologic exam is also indicated after a minor fall or heavy lift in a potentially osteoporotic or elderly person or in patients with a history of prolonged use of corticosteroids. A full neurologic exam is indicated in these patients. In an acute injury, there will be tenderness locally over the spine at the level involved. As a consequence of these factors, the patient may not be able to stand upright with the head balanced over the hips without bending the knees (loss of sagittal balance). In combination with a kyphosis, this loss of height can result in bulging of the abdomen as the contents are compressed and pushed forward. Loss of height also occurs with these fractures, particularly if there are multiple fractures. Conversely, wedge fractures of the lumbar spine can lead to lessening of the lumbar lordosis. neurological disorders (e.g.Patients with multiple wedge fractures of the thoracic spine may have a notable kyphosis, although this can also occur in the absence of vertebral fractures.dietary disorders (e.g., anorexia nervosa/bulimia, inadequate diet, total parenteral nutrition).liver diseases (e.g., biliary sclerosis, sclerosing cholangitis, alcoholic cirrhosis, autoimmune hepatitis).gastrointestinal diseases (e.g., inflammatory bowel disease, coeliac disease, malabsorption syndromes, post-bariatric surgery).endocrine disorders (e.g., hypogonadism, hyperparathyroidism, hyperprolactinaemia, acromegaly, hypercortisolism, hyperthyroidism).rheumatoid arthritis and other autoimmune connective tissue diseases.family history of low bone mass/osteoporotic fractures.previous osteoporotic vertebral compression fracture.: Vertebral fracture-dislocation the patient underwent posterior decompression and instrumented stabilisation Personal collection of Nasir A. : Burst fracture with large retropulsed fragment in spinal canal the patient underwent posterior decompression and stabilisation Personal collection of Nasir A. : Lateral radiograph showing a T12 compression fracture in osteoporotic bone Personal collection of Nasir A. This type of fracture is potentially unstable and requires surgical intervention. Rarely, osteoporotic compression fractures can also involve the middle and/or posterior spinal columns, in addition to the anterior column. Osteoporotic compression fractures of the spine: current options and considerations for treatment. These fractures are traditionally considered benign injuries that heal without complications. ![]() The stability of the spine is not compromised with this type of fracture. Most osteoporotic spinal compression fractures represent an isolated failure of the anterior spinal column due to a combination of flexion and axial compression loading. ![]()
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