[Treatment of osteoporotic fractures of the spine]

Osteoporosis is a skeletal disease characterized by reduced bone strength due to the loss of bone mass, structural disproportion and reduced calcium level as well as changes in the bone structure caused by trabecular deficit. The loss of bone mass in the vertebrae leads to an increased risk of fractures. Osteoporotic vertebral fractures are two to three times more frequent than hip fractures, especially in women. Osteoporotic compressive fractures of the spine mostly occur in the middle and lower thoracic spine and in the thoracolumbar spine. Common consequences of fractures include long-term pains, decrease in the height and spinal deformity, which significantly correlate with disorders in the gait and mobility, reduced pulmonary function, loss of appetite and in the end increased mortality. Clinical picture in acute conditions manifests itself as a sudden pain in the back following minimal trauma but also often without any trauma at all. Diagnostics is based on a detailed medical history and a thorough clinical examination. Radiological diagnosis relies on standard x-rays. In case of clinical indication (differential diagnosis of tumor or spondylitis, neurological weakness) CT and/or MR imaging is performed. The approach to the treatment of osteoporotic fractures of the spine is individual and is based upon the medical history, localization of symptoms and correlation of the clinical examination with the radiological finding. Open reduction, decompression and fixation are indicated in patients with posttraumatic stenosis and neurological weakness. Current operative methods include vertebroplasty and kyphoplasty, which significantly reduce pain and improve mobility of the patient and consequently, the quality of life.