Choi Doo-yong, a professor of neurosurgery at the Catholic University of Incheon St. Mary’s Hospital, explained, “In the case of elderly people in their 60s to 70s or older with osteoporosis, the vertebrae may collapse even with slight external forces such as sneezing or sneezing slightly in their eyes, causing compression fractures.” .
▶ Older people with osteoporosis, sneezing can also result in compression fractures
The spine plays a role in maintaining the structure of the body by supporting the head above and connecting the lower body through the pelvis and hip joints below. In addition, it is an important structure through which nerve bundles pass, and for this function, it consists of structures called vertebral body, intervertebral disc, concubine, and posterior joint.
The spine has a cylindrical shape, and when a fracture occurs, it appears in the form of a compression fracture that shows a decrease or deformation in height. Osteoporotic compression fractures often occur in the thoracic and lumbar vertebrae (back) that support a lot of weight. Severe pain, such as a collapse of the lower back, occurs and is almost impossible to move, and the pain extends to the chest or stomach. It can occur even without pain in the back or lower back, and can occur in the elderly, especially women, who have chronic pain from spinal canal stenosis or disc, etc., slightly banging the buttocks, turning the lower back, or sneezing without major trauma. . The pain is somewhat reduced when lying in a standing position, but when you try to stand up again, you will feel excruciating pain in your back or back. If not properly treated at this time, deformities such as kyphosis in which the body curves forward or scoliosis in the side curves can come. It must be treated.
Professor Doo-Yong Choi said, “Spine compression fractures due to osteoporosis do not end in one-time. There is a characteristic that occurs in a series of vertebrae, but the height of the front of the vertebrae continues to decrease, leading to spinal kyphosis, where the back is bent severely.” He added, “In this case, the back is bent more and more and it worsens with chronic pain. In addition, walking becomes difficult and the overall body function is reduced, causing systemic complications such as pneumonia and breathing difficulties,” he added.
▶After diagnosing osteoporosis, it is necessary to prepare for fracture with steady management.
To diagnose osteoporotic vertebral compression fractures, spine x-rays are first performed. However, X-ray examination can confirm that the height of the vertebral body has subsided, but this examination alone cannot clearly determine whether it is an acute fracture or an old fracture. Therefore, spine MRI (Magnetic Resonance Imaging) is performed as the most reliable diagnostic test to determine the extent and time of occurrence of the fracture. When a fracture occurs, a fracture fragment (a sharp piece of a broken bone) is produced, and it is very important to establish a treatment plan because it is possible to accurately determine whether or not the nerve is compressed by the bone fragment. Finally, the presence and extent of osteoporosis are checked through a bone mineral density test or blood test related to bone metabolism, and the treatment policy is determined after all test results and patient conditions are checked.
In the case of an acute fracture, conservative treatment such as bed rest and pain relievers should be performed for 2 to 3 weeks. Then, various osteoporosis drugs related to osteoporosis, calcium, vitamin D, and other medications are started. If the pain is significantly reduced by this conservative treatment, the patient starts walking while wearing a lumbar brace and continues the medication. However, if severe pain persists or the vertebral body height decreases even with such treatment, considering that most patients are elderly, vertebral body plastic surgery is performed in which medical bone cement is injected through injection under local (partial) anesthesia. In this case, there is an advantage in that severe pain can be improved in a short time.
Rarely, if the initial fracture is severe or the bone fragments compress the nerve, the nerve is released through general anesthesia, and surgical treatments such as screw fixation to stabilize the fractured vertebrae and surrounding nerve tissue are sometimes performed. However, as most of these patients have chronic diseases such as old age, diabetes, or high blood pressure, it is important to make a treatment plan through consultation with a specialist before surgery.
Prof. Doo-Yong Choi said, “Osteoporotic spinal compression fracture is a disease that increases medical and economic burdens and mental and physical fatigue on the family and society beyond individual problems. After being diagnosed with osteoporosis, it is continuously managed like other medical diseases such as high blood pressure or diabetes,” “If not properly treated, fractures may occur in various parts of the spine, hip joints, wrists, and so on, and you may have to undergo surgery, and you may suffer from various complications. This is not limited to short-term treatment, but lifelong management and treatment. “It should be recognized as a disease that is caused by the disease.”