Osteoporosis and the Spine
Osteoporosis is a condition characterised by reduced bone density and quality, making bones fragile and more prone to fractures. The spine is one of the most commonly affected areas, and vertebral compression fractures (VCFs) are the most frequent osteoporotic fractures — more common than hip fractures.
An estimated 50% of women and 25% of men over 50 will experience an osteoporosis-related fracture in their lifetime. Spinal fractures often occur without any significant trauma — simply bending, lifting, or even coughing can cause a vertebral fracture in severe osteoporosis.
Silent Epidemic: Most osteoporotic vertebral fractures go undiagnosed. Gradual height loss, increasing kyphosis (rounded upper back), and back pain in older adults should prompt a DEXA scan.
How Osteoporosis Affects the Spine
- Vertebral bodies lose trabecular bone density → become susceptible to compression fractures
- Multiple VCFs lead to progressive kyphosis (dowager's hump) and height loss
- Kyphosis shifts the centre of gravity forward → further fractures and falls
- Chronic pain, reduced lung capacity, and impaired quality of life
Symptoms
Diagnosis
- DEXA scan — T-score measures bone mineral density; T-score ≤ -2.5 = osteoporosis
- X-ray spine — identifies vertebral fractures and deformity
- MRI — distinguishes acute from old fractures; identifies treatable fractures
- Blood tests — serum calcium, Vitamin D, PTH, thyroid function