Osteoporosis and Its Latest Treatments – Dr. Krishna Subramaniyam

What is osteoporosis?

Osteoporosis is the decrease in the compactness of the bone due to the loss of mineral content of the normal bone. As we advance in age and also some other reasons like the continuous take of medicines or lack of activity, we may lose mineral content of the bone which causes weakening of the bone, therefore, increasing the fragility of the bone causing fractures – this is called Osteoporosis. Osteoporosis is usually seen in elderly people or chronically depleted people or malnourished people or people with some kind of drug intake like steroids.

How is osteoporosis diagnosed?

Osteoporosis is diagnosed usually by a special scan called DEXA scan or Quantitative CT scan where the bone mineral content is calculated in the patient or individual and compared against a young adult’s bone mineral density and also age-matched bone density. Therefore, based on these, two important scores called T score and Z score are evaluated, wherein the doctor knows what score is at what level and can give the diagnosis if it is Osteoporosis.  Therefore, Osteoporosis is diagnosed by DEXA scan.

What would the treatment plan for a patient with osteoporosis include?

The treatment for osteoporosis has changed in the last couple of decades. Conventionally, osteoporosis is treated with calcium supplementation, but calcium supplementation alone is not sufficient. Vitamin D supplementation and a balanced diet are essential parts of treating osteoporosis along with calcium supplementation. The latest treatments are divided into two important things one is, Antiresorptive therapy and the other one is Osteoblastic improvement therapy. In antiresorptive therapy, we have bisphosphonates and oral bisphosphonates, and injectable bisphosphonates. The injectable molecules are bisphosphonates, we commonly use zoledronic acid which can be given under doctor supervision in the hospital once in 6 months or once a year. Coming to the latest antiresorptive therapy, it is called the dense map. This is a small injection that comes in a prefilled syringe, which can be given once in 6 months. A simple shot helps in improving osteoporosis. Coming to improving the bone formation or osteoblastic activity, improving therapy. We give a regular subcutaneous injection of teriparatide, these are the two important molecules that can change the osteoporosis treatment today. 

Is this spine is involved in osteoporosis how is it treated?

Spine involved in osteoporosis is very common these days, any triggered trauma or any small fall or injury, for example, fall on the buttocks in an elderly man or woman results in an osteoporotic compression fracture of the spine, and when the patient presents to us, we advise bed rest and give the treatment of osteoporosis, like osteoblastic molecules or teriparatide injections, calcium supplementation, and for the pain to be relieved following the fracture, we give an injection of the bone cement into the fractured vertebrae. This is called Vertebroplasty. This is how spinal osteoporosis can be treated.

How is osteoporosis prevented?

Osteoporosis treatment primarily should start from a very young age. Regular physical exercises, balanced nutrition, and a regular intake of calcium and vitamin D can help prevent osteoporosis.