WHEN TO SEE A SPINE SPECIALIST

You should seek the advice of a spine specialist if neck or back pain persists for more than two weeks or if it is progressive in intensity and/or distribution. You should seek immediate healthcare attention if neck or back pain occurs as the result of an injury or if it is associated with serious illness and/or a high fever. Additional signs and symptoms which warrant prompt medical attention include:

• Neck or back pain associated with bowel and/or bladder dysfunction
• Neck or back pain associated with extremity weakness or difficulty with coordination
• Extremity numbness or muscle weakness
• Neck or back pain that is associated with impaired walking (gait) or difficulty with balance
• Numbness, tingling and/or muscle weakness associated with a back or neck injury

Seek professional advice if osteoporosis is diagnosed or if you fail a bone density screening/study. Seek professional advice if you suffer any type of compression deformity or fracture. If you are at high risk for developing osteoporosis seek medical advice to implement an appropriate screening and prevention protocol.

SCREENING AND DIAGNOSIS

The term osteopenia refers to mild bone loss that is not severe enough to be called osteoporosis.  Doctors are able to detect thinning of the bone including nearly osteoporosis using a variety of devices to measure bone density. The best screening test is dual energy X-ray absorptiometry (DEXA). This procedure is quick, simple and gives accurate results. It measures the density of bones in your spine, hip and wrist — the areas most likely to be affected by osteoporosis — and it’s used to accurately follow changes in these bones over time. Other tests that can accurately measure bone density include ultrasound and quantitative computerized tomography (CT) scanning.

If you're a woman, the National Osteoporosis Foundation recommends that you have a bone density test if you aren't taking estrogen and any of the following conditions apply to you:

• You use medications such as prednisone that can cause osteoporosis.

• You have type 1 diabetes, liver disease, kidney disease or hx of osteoporosis.

• You experienced early menopause.

• Postmenopausal, > than 50 and have at least one risk factor for osteoporosis.

• You're postmenopausal, older than 65 and have never had a bone density test.

NATURAL HISTORY AND PROGNOSIS

Osteoporosis is usually a progressive disorder complicated by advancing age and related hormonal changes. New treatment methods with lifestyle modificaotn can slow the process and in some cases help increase bone density. The progressive thinning of bone due to osteoporosis increases the risk for compression fractures and fractures associated with trauma. As many as one out of three women will experience an osteoporosis related fracture during their lifetime.

COMPLICATIONS

The term spontaneous refers to rapid onset and without foreseen risk.  A fracture of the spine can occur during the course of normal activities in the presence of an underlying bone thinning disorder such as osteoporosis.  The most common predisposing condition is a loss of bone density or integrity.  The bone which makes up the vertebral body must be strong enough to withstand the high loads placed upon it during the day.  Any loss of the bone density can lead to abrupt or gradual collapse of the bony architecture.  A spontaneous spine fracture can occur whenever there is a loss of a bone density.  An aggressive lesion or tumor within bone can lead to a loss of bone density rendering the vertebra more susceptible to collapse and deformation.