Osteoprosis is a disease of bones that leads to reduction of mineral content in the bone. This results in weakened bones which become highly susceptible to fracture, even with trivial trauma. Cancellous bones like spine loose mineral early. Fractures of spine in osteoprostic indviduals tend to be compression fractures mostly. This is due to progressive collapse of vertebral body.
These osteoporotic compression fractures are occasionally accompanied by radicular pain and rarely by neurologic deficit.
Most of the patients are quite elderly. The usual presentation is of severe back pain which can be often accompanied radiating pain. Neural deficit is rare.
Blood investigations could be normal or may suggest other geriatric comorbidities. Xrays is the basic investigation and often only required image investigation. CT and MRI are usually not required in diagnosing osteoprotic fractures but to rule out some other pathology like malignancy.
Most of these fractures get better by analgesic medication and rest. Bracing can be given but is not well tolerated in elderly patients who sustain these injuries.
In situations where there is a significant neurologic deficit, disabling deformity, or marked pain, surgery can be a reasonable option.
Open surgery is reserved for patients with neurologic deficits or intractable pain associated with a severe spinal deformity.
Posterior segmental instrumentation, usually with pedicle screws, is often performed to supplement anterior surgery in osteoporotic patients with more significant thoracolumbar trauma.