Osteoporosis, the disease of bones that is expected to impact over 36 million patients in India by 2013, is the single largest cause of spinal fractures. 20 per cent of women and 10 to 15 per cent of men aged above 50 suffer from Osteoporosis.
Despite 83 per cent of all spinal fractures occurring due to Osteoporosis, the disease significantly lacks the required awareness, diagnosis, preventive and treatment measures.
The repercussions of spinal fractures can be severe. Spinal fractures can result in stooped back or change in spinal alignment, acute and chronic debilitating pain, loss of height, immobility, depression, significant performance impairments in physical, functional and psychosocial domains in older patients.
It leads to five fold increase in risk of future spinal fractures after the first fracture and 75 fold increase in risk after two or more spinal fractures.
Patient experiences reduced pulmonary function, increased dependence on family and even premature death. These fractures are associated with difficulty in many activities of daily living, all leading to a negative impact on quality of life.
Early diagnosis and prevention of fractures can help patients avoid these severe consequences. Patients and treating physicians should keep a watch on following symptoms that can be a cause of spinal fracture.
These include loss of height, sudden, severe back pain, an increase in stoop in spine, family history of Osteoporosis.
Osteoporosis is a disease of bones characterised by decrease in the density of bone and bone mass resulting in fragile and weak bones.
The bones become extremely week or porous and prone to multiple fractures even due to a slight fall or bump. Osteoporosis, has no signs or symptoms until a fracture occurs, hence it is often called a 'silent disease'.
Osteoporosis is hugely under diagnosed and under-treated in India. The problem is particularly worse in rural and semi-urban areas. In urban regions, Osteoporosis is widely prevalent due to poor lifestyle pattern of the people. Widespread deficiency of Vitamin D and Calcium are also key factors.
The major Osteoporotic fractures occur in the spine, wrist and the hip bones. Between 25 and 60 percent of women, aged over 60 years develop spinal compression fractures. There are two interesting features about the Osteoporosis in India — the high incidence among men d the lower age of peak incidence as compared to Western countries.
The incidence of Osteoporotic hip fractures is 1 woman: 1 man in India, while in the Western world, it is 3 women: 1 man. And in most western countries, while the peak incidence of Osteoporosis occurs at about 70-80 years of age, in India it afflicts those at age 50-60”.
Said Dr Upendra, Spine Surgeon, “Spinal fractures caused by osteoporosis are all too often dismissed as simple back pain or arthritis hence and so often do not come to clinical attention, thereby remaining undiagnosed and untreated.
Even when referred to a doctor, only about 40 per cent of older women with spinal fractures visible on X-ray are tested for osteoporosis and the figure is even lower in men (less than 20 per cent).
It is essential that spinal fractures are identified and treated before further fractures occur. Unless treated, as many as one in five women with a spinal fracture will sustain another within twelve months”.
Data suggests that even amongst patients who are recommended a surgical intervention for spinal fracture, very little percentage actually receive the right treatment.
One of the major reasons for patients dropping out of surgical procedure is 'fear' of surgery.
Unfortunately, despite the marked improvement that medical science has made over the decades, Indian patients suffer from a psycho fear and prefer leading their life in pain rather than performed on right treatment. Procedures like Balloon Kyphoplasty, Vertebroplasty, etc when performed on right patients by trained physician can lead to miraculous improvement in patient's quality of life.
"Spinal fractures represent a significant socio-economic burden. It is estimated that around the world, one spinal fractures occurs every 22 seconds. Conservative estimates suggest that India will have 36 million Osteoporotic patients by 2013. Therefore, there will be a marked rise in costs in decades to come. Hence, prevention of all Osteoporotic fractures, early diagnosis and treatment must be a key public health goal," he further added.
This will help reduced disease burden along with significant improvement in quality of life of those who suffer from Osteoporotic Spinal fractures.
Open spinal surgery is an invasive procedure that is generally considered if neurological damage is present. A less invasive surgery technique called Kyphon Balloon Kyphoplasty can treat pain and improve quality of life faster and better than conventional non-surgical treatment and has proven safety. Balloon Kyphoplasty is a minimally invasive procedure performed by a spine specialist. It can be performed using either a local or general anaesthesia. It typically takes about one hour to treat each fracture and may require an overnight hospital stay.
Balloon Kyphoplasty gently restores the height of the vertebra and corrects deformity by inflating two balloons in the fractured vertebra through small incisions in the skin.
Once height is restored, the balloons are removed and the cavity they create is filled with thick bone cement at low pressure.
Balloon Kyphoplasty is a minimally invasive procedure that takes in general less than an hour to perform and leaves minimal scarring.