Spinal Osteoporosis and Fracture Risk Factors

Due to hormonal changes, spinal osteoporosis is more common in patients over 50 years of age and four times more common in women than in men. It is worth noting that:

• It is believed that only 30% of vertebral compression fractures are actually diagnosed, ¹ Lau E, Ong K, Kurtz S, Schmier J, Edidin A. Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Joint Surg Am. 2008;90(7):1479-86. indicating that spinal osteoporosis—and the resultant fractures—is more common than thought.
• Research shows 25% of all post-menopausal women in the United States have had a vertebral compression fracture from osteoporosis. ² Old JL, Calvert M. Vertebral compression fractures in the elderly. Am Fam Physician. 2004;69(1):111-6.
• Vertebral compression fractures become more prevalent with age, with as much as 40% of women 80 years of age sustaining a vertebral compression fracture. ² Old JL, Calvert M. Vertebral compression fractures in the elderly. Am Fam Physician. 2004;69(1):111-6.
• While less common in older men, who are not as prone to osteoporosis, compression fractures are also a significant problem.

Vertebral compression fractures not only cause physical symptoms, including pain and stooped posture, but can also be emotionally distressing to the patient, who may face some loss of independent function.

It is significant to note that both men and women suffer a significantly higher mortality rates after a compression fracture, although this is not necessarily a causal relationship; there are often numerous comorbid conditions and factors which could be responsible for the higher mortality rate. ¹ Lau E, Ong K, Kurtz S, Schmier J, Edidin A. Mortality following the diagnosis of a vertebral compression fracture in the Medicare population. J Bone Joint Surg Am. 2008;90(7):1479-86.

Treating vertebral compression fractures is less expensive than treating hip fractures; however, vertebral compression fractures can have a substantial negative impact on the patient’s function and quality of life. Acute and chronic pain in the elderly commonly is attributed to severe pain from vertebral compression fractures, and often leads to further disability. ² Old JL, Calvert M. Vertebral compression fractures in the elderly. Am Fam Physician. 2004;69(1):111-6. By the same token, it must be noted that not all vertebral compression fractures cause symptoms and indeed many are found as asymptomatic findings on an imaging study.