How do we address breaks and paragraphs are caused by osteoporosis?
How do we address breaks and paragraphs are caused by osteoporosis?
Recorded annually in the United States more than 1.5 million cases of fractures caused by osteoporosis.
The fractions of the paragraphs, which occupies its bones in the spine, about half of all injuries almost.
And increase the number of injuries fractures paragraphs weak almost on the numbers of injuries broken pelvic bone. The percentage of women who are mining menopause menstruation and had contracted a broken paragraphs to 25 per cent.
Unlike the pelvic bone fractures, which often result from falls, fractures, the passages do not usually occur, only slightly as a result of the shock directly, but the paragraphs which become weak due to osteoporosis are not able to resist the stress and pressure by natural, therefore, developed as soon as influenced by simple movement, such as bending, or rapid rotation, or raise the weight is simple.
Breaking paragraphs
Do not show any symptoms to break the paragraphs in the two-thirds of cases occur, as they remain undiagnosed for a long time to appear, for example in X-rays that are picked for the diagnosis of other health problems.
It would appear that the fraction in paragraph one does not lead to any serious consequences, but the presence of only this fraction could lead to long-term interventions, including the high risk of the occurrence of new fractures.
In research published in 2007 in the medical journal, U.S. researchers found in the «study of fractures caused by osteoporosis» (Study of Osteoporotic Fractures) that women who have had a history of fractures of the paragraphs, have increased to four times the risk of new fractures during 15 years of follow-up .
Provision is also to have a greater risk in the incidence of fractures in other bones, especially in the pelvic bone.
Can the effects of cumulative multiple fractures lead to devastating health problems, as the chronic pain, disability, and difficulty participating in everyday life lead to isolation, and problems in family relationships, emotional problems, including depression that appears in 40 per cent of people with broken paragraphs .
It also increases the risk of breaks and paragraphs are premature death, but not increase the degree of danger due to a broken pelvic bone.
As the population ages it is expected to increase rates of fractures caused by osteoporosis, but we fortunately have the means to treat these fractures more than we had 10 years ago, including steps to ease the pain, and support and the assignment of the broken paragraphs, and reduce disability.
The consequences of breaks and paragraphs are
The paragraph does not break the normal sense of the break, they do not like Tnqsam branch, or as men, arm Almaxorten, but they break down and bow down on itself, collapsing as a cup made of paper when it tramples on your foot. And terminology is common for this type of fracture is «strut fracture» (compression fracture).
The pain may be caused by the sharp fracture or mild, the patient may feel in place or in a position far from his side when the abdominal region.
In many cases, not showing any pain, or appears dull pain, and be the mark to break reduced height and bowing forward.
Depends diminished height and distortion in the shape of the number and positions of the fractions.
The majority of infected people suffer fractures paragraphs break in the case of a single paragraph or two paragraphs. The most common fracture was in the area located behind the chest (center back), and in some cases in the lumbar (lower back).
s hump)." onmouseover="this.style.backgroundColor='#ebeff9'" onmouseout="this.style.backgroundColor='#fff'">Not lead to breaking the case of a single paragraph or two only a very small decline in height, but multiple fractures could lead to warp back in the so-called situation Cams dorsal (dorsal kyphosis) or a «widow hump» (dowager> s hump).
And dorsal kyphosis caused by a number of factors, including degenerative changes in joints, vertebrae, bones, and therefore able to strongly influence the form of rights and the movement and health.
And lose the backbone of righteousness is growing, and take the form erratically. And dispels the upper part of the body hunched forward, and take in shrinking the distance between the bones of the rib cage and pelvis, and squeeze the chest wall, Tenshak organs in the abdominal area, causing the region to push forward.
In some severe cases who experience difficulty breathing, and a bug in the process of digestion.
And able to compression fractures resulting from the backlog that cause physical disability and functional as the cause pelvic bone fractures.
The pain turns to chronic pain after having back muscles to play a greater effort to adapt to the fractures. The patient needs to stick to assist him in walking, and may not afford a ride in the car for more than several minutes.
What to do?
Can be ascertained from a fracture in paragraphs X-ray imaging. Typically, the strut breaks and paragraphs occur in women after menopause menstruation because of osteoporosis, but it may occur as a result of exposure to trauma, or infection, or tumor.
And start treating the painful breaks and paragraphs are diluted with medication for pain available without a prescription, such as «acetaminophen» acetaminophen ( «Tylenol» Tylenol), aspirin or «Ibuprofen» ibuprofen ( «Advil» Advil or «Motrin» Motrin).
The severe pain requires absolute rest in bed for a short period and medication stronger from small doses of opiate drugs such as opiates «Ooxhexodon» oxycodone ( «Ooxhexontin» OxyContin), which is often described with «acetaminophen».
However, it must avoid the comfort in bed for a long time, because it may contribute to the demolition of the bones and the occurrence of other health problems. It may also help the development of pieces of ice packs, or hot compresses on the painful area to relieve pain.
It is recommended that normally put the back brace to ease the pain and to restore stability to the spine, during his recovery.
Almelvav and designed to push the spine to take are more upright than it is, the ease pressure on the affected paragraphs, and reduces the likelihood of damage to other paragraphs.
Healing takes a period of three months. Almelvav should not be used for a period longer than that because it may lead to weakening of the muscles of the trunk.
Once people can carry the movement after this period, the professionals usually encourage them to do light physical exercise such as swimming or walking, and after then they can do other exercises to strengthen the muscles of the trunk.
Osteoporosis drug also must be examined to assess the degree with osteoporosis have measured bone mineral density and osteoporosis should be treated with standard medicines, and drugs «Alpefosfonayat» bisphosphonates, such as «Olindronit» alendronate ( «FOSAMAX» Fosamax) and «Rayazdronet» risedronate ( «Oktonil» Actonel) and «Iibandronit» ibandronate ( «Boniva» Boniv).
The drugs can «Alpefosfonayat» help alleviate acute pain, but the first task is to improve bone mineral density.
In the long run, it helps reduce the rates of new paragraphs break by up to 50 per cent.
The injection «Alpefosfonayat» - such as the «acid Zuldronic» zoledronic acid ( «Ericlast» Reclast, «Zumita» Zometa) and injections of a medicine «Boniva» - they are alternatives for women who can not take the drugs by mouth.
The drug is the last of the bones «Calcitonin» calcitonin (Mayacalcen »Miacalcin,« Forticll »Fortical) it is less effective to improve bone mineral density, but that it can frighten the pain, although it is not considered as compensation for grain mitigating pain, while increasing drug« Tiribaratned »teriparatide (« Vortillo »Forteo), which is given in the form of injection, bone density and reduces the risk of breaking paragraphs.
The evaluation of paragraphs
There are two ways Alajitan Ttzmann the lowest form of intervention: Surgery Calendar paragraphs vertebroplasty and orthopedic surgery Hump (Cdodab) kyphoplasty, and comprising the process of injecting medical cement works on the stability of paragraphs pressurized.
These Alamili has begun in the United States in the nineties of the last century, and becoming one of the types of treatments are available to the pain of fractures that do not respond to other types of conservative treatment.
According to Dr. John that a specialist in Radiology Brigham and Women's Hospital in Boston, the back brace and pain medication extenuating used first in the beginning «to see whether the fracture will heal itself.
If not, we remained patient suffering from pain - after four to six weeks usually - when that should be considered in the conduct of operations ».
There are very few studies that compare control effectiveness of the two paragraphs and orthopedic surgery orthopedic surgery Hump, and safety, in the long run, whether the comparison between the two processes or in between them and the conservative ways.
It is also not clear whether each one of these processes improve the stability of the spine or prevent the occurrence of fractures in the long term.
But the main reason for these two processes is the continuation of the pain, say 85 to 90 per cent of those who underwent two operations to ease the pain they felt immediately.
The study found review of 21 studies involving 1039 patients, published in 2007 in the journal «Pine Vezichiyan», that both processes reduce the pain by more than 50 per cent.
No one knows exactly how these processes lead mission.
There is one of the theories that pain is often a type of inflammatory response resulting from the unequal distribution of mechanical forces that lead to broken bones.
It is believed that cement helps to stabilize the affected paragraph, which reduces inflammation and reduces pain the result.
It is also is also likely to cement destroys the nerve endings in the paragraph, which carry pain signals.
Prior to any of the processes of the injured subject Almrnan magnetic imaging device to show the usefulness of conduct.
The patient, who will undergo the process is Almrnan magnetic images show him a bone edema (bone edema), or the presence of liquid, which is linked to the presence of broken conversation.
If there were not the case of bone edema, this means that the fracture has healed and it is not the position that causes pain.
Images can also Almrnan magnetic confirm the existence of problems in the spinal cord or paragraphs or muscles of the spine.
And implement the processes of orthopedic surgery paragraphs and Camber, through the skin, in the clinic every day, and often the patient is under anesthesia and conscious through it.
Full anesthesia is used if multiple fractures or severe or the patient is too old or sick, or can not never lie on his stomach.
Orthopedic surgery paragraphs
Is a specialist in radiology or surgery, neurosurgery, orthopedic surgery employ CT imaging systems class, computer or X-ray imaging systems in real time, by introducing hollow needle through a small incision in the skin around Almndguet section of the paragraph.
When you reach the needle to the position it is injected Cement surgical article «bromide Mithakrlat» methyl methacrylate, which has properties similar to toothpaste.
Is mixed this article with a substance that facilitates the vision specialist in the cement as it flows towards the paragraph affected.
The cement hardens within 15 minutes, and the patient is monitored for two or three hours in the lobby of healing before being allowed to return to his home.
Orthopedic surgery Camber
This process is also carried out employing imaging systems, are being hard skin in the back and the introduction of inflatable balloons can be placed in the tubes, through both sides of the paragraph affected.
After blowing up balloons gap allows the paragraph to return to upright position. Then being unloaded balloons and withdrawn, and then fill the gap with concrete.
The operation will continue for a period of 30 to 60 minutes of each paragraph is damaged, the patient may spend the night in the hospital.
Risk assessment processes
The processes of assessment and evaluation of paragraph Hump conducted by experienced specialists generally safe, but anesthesia is always dangerous, and the nerves may be damaged due to the introduction of needles, in addition to that each process is the incision of the skin carries the risk of bleeding or infection.
It also raises the fears of cement leakage, but the worker who monitors things in real-time imaging systems employing x-ray, can monitor and stop the injection.
It is interesting to concerns that really is leaking cement to the sites where he can cause serious problems, in the spinal canal, for example, a Cement pressure on the spinal cord, or they can leak into the bloodstream, which may cause the formation of blood clots move to the heart and lungs.
However, these complications are very rare in cases of treatment of fractures resulting from paragraphs osteoporosis (except that the compressibility of other fractures caused by tumors or infection or trauma may be worse or be multiples more).
And help with the real choice to avoid complications as well as the likelihood of leakage of cement, so you must estimate the proportion of strut fracture accurately, and to avoid conduct that was the subject of the two processes close to the channel fracture of the spine.
The long-term effects of Cement paragraph is still not known, researchers are studying the possibility that the presence of cement over the risk of breaks and paragraphs are nearby, perhaps induced by changes in mechanical forces.
Some doctors believe that people submit to one of these processes as a first option, instead of waiting four to six weeks to judge the results of drug therapy, and the use of back brace, and the commitment of rest in bed.
However, the majority believes that we are prudent to the door - and while our knowledge of the dangers of processes and Totherathma long-term - to try conservative treatments before everything else. Finally, you are preparing for one of these processes, you must choose the best hospital with the two experiences, and better imaging systems.
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