Transcript of video
Osteoporosis causes and spinal surgery. What are ultimate causes of osteoporosis? Dr. Anton Titov, MD. Age-related degeneration of spine is the main reason for spine surgery. Osteoporosis makes every type of spinal surgery more difficult. Leading spine surgeon discusses how to overcome osteoporotic changes when spine surgery is required. How kyphoplasty and vertebroplasty have not fulfilled initial expectations of treating osteoporotic compression fractures. Osteoporosis causes and spinal surgery. Back surgery for osteoporosis is required when compression fractures occur. Osteoporosis is caused by progressive loss of bone calcium after menopause. It is important to build calcium in bone before age 30. Video interview with leading expert in spine surgery. Osteoporosis causes and spinal surgery make a complicated situation. Osteoporosis leads to spine fractures by mechanism of vertebral compression. Surgery for osteoporosis of the spine is indicated to inflate collapsed vertebrae. This is called kyphoplasty abd vertebroplasty. Medical second opinion helps to determine if vertebroplasty or spinal fusion sue to osteoporosis can treat the patient. Medical second opinion also helps to choose the best method to treat vertebral fracture due to osteoporosis. Seek medical second opinion on osteoporosis-related fractures to be confident that your treatment is the best. Management of osteoporosis in spine surgery demands greater length extension for the hardware because screws do not hold well in osteopenic bone. Osteoporosis in cervical spine can manifest by neck pain and hand numbness. Back pain in elderly could mean a spine compression fracture that requires surgical operation. Osteoporosis causes are many. Often spinal surgery is required in patients with osteoporosis. Back pain is a frequent symptom of osteoporosis of the spine in men. Back surgery for osteoporosis. Osteoporosis complications prevention. Dr. Anton Titov, MD. Osteoporosis is a very big problem, especially in the aging population. In your practice you see effects of osteoporosis, the compression fractures. How should patients prevent osteoporosis? Dr. Anton Titov, MD. How to treat osteoporosis? Dr. Anton Titov, MD. What advice you give to patients regarding this very common condition? Dr. Anton Titov, MD. Dr. Eric Woodard, MD. Sure. Osteoporosis can be a very challenging problem for spine surgery. In general, osteoporosis, as you know, is a complicated process. In osteoporosis the bone loses its mineral contents. The bone loses its calcium content. This can be on a genetic basis individually. It can be on the basis of genetic ancestry. Typically the Scandinavians and the Northern Europeans are much more prone to osteoporosis than Southern Europeans or Latin Americans. there is clearly a genetic predisposition toward developing osteoporosis. Your bones take on and accumulate calcium and phosphate at approximately constant rate to about age 30. then you slowly lose mineral at a fixed rate. Some of this is hormone-based, as you know. in women once the hormonal changes at menopause occur, they will have an abrupt increase in the rate of loss of mineral of their bone. Since the curves are relatively similar in their shape, clearly the higher the mineral content you can achieve up to age thirty, the higher relative amount of mineral you’ll have when your age is 60…70…80. this is the reason behind a strong recommendations and in children and teens and young adults to maximize their nutrition. Especially with regard to taking calcium. Typically this is done with dairy milk products, things like that. Certainly nutritionally depleted or nutritionally deficient individuals in their youth will have higher risk for osteoporosis later. Osteoporosis can be devastating in the elderly population who fall below certain thresholds in the spine especially. Dr. Eric Woodard, MD. this is most typically at the highest stress points in the spine, the midpoint of the thoracic spine, for instance. The vertebrae nearly collapse due to mechanical failure. when they collapse obviously there is a tremendous amount of associated pain . This can be debilitating. In rare cases the collapse associated with narrowing or cord compression. This can be devastating from a neurological standpoint. In recent years there has been a lot of interest in treating osteoporosis aggressively. Treatment includes injection of various types of cement into the fracture. Or even reducing or essentially re-inflating the vertebrate with percutaneous or needle-based balloons. The cavity is then filled with some cement. That is called a vertebroplasty procedure or a kyphoplasty procedure. Both these have been around for a number of years now. Vertebroplasty and kyphoplasty are widely practiced. Now, just like any treatment, it is only is good until you study it rigorously. Some of the more recent rigorous outcome clinical trials have shown only marginal and transient benefit of both vertebroplasty or kyphoplasty. that it is more of an option rather than a recommendation for folks who have severe symptomatic osteoporosis related fractures. Osteoporosis is a particular challenge in folks that have other spine pathologies. Especially in patients who we are considering for surgery. Dr. Eric Woodard, MD. We talked about spine surgery indications for deformity, stenosis, and spondylolisthesis. To do standard surgical procedures on these folks with osteoporosis challenges us. Because the typical fixation devices that we use for a standard patient prove inadequate in patients with osteoporosis. Screws don’t hold, many times we have to spread out the stress and make the constructs stronger or even longer. that there is a mechanical advantage in this very poor area. It is very thin bone that will not hold screws, for instance. Dr. Eric Woodard, MD. Osteoporosis is increasing, it is a challenge. Osteoporosis needs to be prevented ideally. There are a number of options to prevent osteoporosis fractures, both surgical and non surgical treatment of these maladies. Osteoporosis causes and spinal surgery. Video interview with leading spine surgeon. Best therapy for osteoporosis? Dr. Anton Titov, MD. How to keep spine healthy into the old age? Dr. Anton Titov, MD.