WHAT IS OSTEOPOROSIS?

Due to the increasing average age, bone thinning and related problems are also increasing rapidly.

Our hospital has physicians and medical staff experienced in the treatment of diseases that may occur as a result of osteoporosis, with the recognition of osteoporosis known as bone thinning with its technical and medical equipment.

OSTEOPOROSIS

Osteoporosis is a disease known as bone thinning among the people. It is made up of the words osteo (bone) and porosis (porous). The World Health Organization defined osteoporosis as "a disease characterized by low bone mass and a tendency to bone fragility and increased fracture risk as a result of deterioration in the microstructure of bone tissue".

Bone is a living and developing tissue made of calcium and protein. While new bones are being made, old ones are destroyed. During the development period, bone structure increases over time and bones become stronger after a certain age (varies from person to person) and this bone formation decreases and stops. Bone destruction gradually increases over time and bones become weaker as age progresses. So bones become fragile. Bone loss often occurs in the waist bones, wrist, shoulder and hip area. These regions are the regions where fractures are common in advanced ages.

Bone mass usually begins to decline from the age of 35. After the growth is completed, 30-50% of the bone tissue in women and 20-30% in men disappears in time. Menopause in women is an important factor that accelerates bone loss.

OSTEOPOROSIS TYPES

·        TYPE 1: It is common in women between the ages of 50 and 70. The loss in bone mass is large.

Spine and wrist fractures are more common. Hormonal changes are seen.

·        TYPE 2: It is seen over the age of 70. Although it is common in women, it can also be seen in men.

There is a loss in the whole of the bone. There is a high risk of bone fracture. Generally, it is more common in the postmenopausal period in women. It can be seen as a result of some diseases in men. Sometimes the exact cause of osteoporosis is not known exactly, but the following factors facilitate the development of osteoporosis:

·        Aging

·        Reduced movement

·        Decreased estrogen hormone level

·        Cortisone use

·        Excessive thyroid hormone secretion

·        Excessive alcohol intake

·        Smoking

OSTEOPOROSIS SYMPTOMS AND DIAGNOSIS

Many people are not aware of bone loss, but notice it only when fracture occurs. We do not understand it under normal conditions, since bone loss is a very slow event, it does not cause obvious complaints. The first findings in osteoporosis are height shortening, rounding in the shoulders and hips, and waist and back pain. If the disease is suspected, bone measurement should be done.

 

Bone Density Measurement

Bone density measurement is an examination performed with an instrument that can measure minerals in the bone. It is generally measured with devices called densitometers working with dual energy x-ray principle. The examination time is approximately 15 - 20 minutes. Measurements are made from hip, waist or both areas as standard. The examination is not painful and uncomfortable and there is no known risk.

This examination only shows the mineral structure in the bones, but does not show the microscopic structure of the bone. Therefore, it does not specify the exact state of bone strength. This examination shows the tendency of the bone to break, but does not show when it will happen.

At the end of the measurements, T score (standard deviation of the comparison of the patient with the young reference group), Z score (standard deviation of the patient compared with the same age group) are determined.

Bone Density Measurement Assessment:

·        Normal: T score is between 0 and -1.

·        Low bone mass (osteopenia): T score is between -1 and -2.5.

·        Osteoporosis: T score is below -2.5 (ie bone loss is more than 25% compared to normal people).

·        Severe osteoporosis: T score is below -2.5 and there is osteoporosis-related fracture.

Is Bone Density Measurement the definitive diagnosis method in Osteoporosis?

Bone density decreases with age. Bone density has decreased in almost all the elderly compared to young adults. One study found that 66% of women over the age of 40 (compared to young adults) were predisposed to osteoporosis or osteoporosis.

Bone Density Measurement is not the definitive method of determining bone strength in osteoporosis. Because bone strength is a common indicator of bone density and microscopic structure of the bone. Only the density can be measured with an examination. In other words, it does not mean that a fracture will occur in every person with decreased bone density. In addition, the decrease in bone density is only one of the reasons that increase the risk of bone fracture. Less movement, unbalanced diet, medication use, balance problems and some other diseases can cause bone weakening. With today's treatment methods, bone loss is slowed down, but the lost bone tissue cannot be replaced.

PROTECTION FROM OSTEOPOROSIS

Being protected, Preventing bone loss

We must protect our bones. The most effective treatment for osteoporosis is prevention of bone loss. Bone loss can be slowed with some simple measures.

·      Organize your diet, get enough calcium and vitamin D

·      Do not smoke

·      Avoid sudden weight loss

·      Do exercise regularly

·      Do not use unnecessary medication

Reducing the Risk of Fracture

·        Do not use alcohol

·        Wear suitable, non-slip shoes

·        If you have visual impairment, have an eye examination and wear glasses to avoid tripping

·        Remove any objects in the wasy at home (door sill, carpet, toy, power cord, etc.).

·        If you are using sleeping pills or sedatives, go out with someone or use a support such as a cane because you may fall as a result of languishment or carelessness.

·        Organize your lifestyle and diet

·        Talk to your doctor and find out if hormone treatment or other drug treatment is needed.

OSTEOPOROSIS TREATMENT

Drug therapy in osteoporosis

With an appropriate treatment, the risk of fracture can be reduced by 60%. Basically 3 groups of drugs are used:

·        Drugs preventing bone destruction. Ex: Alendronate, calcitonin, Zoledronic acid

·        Drugs that increase bone formation. Ex: D vit, parat hormone

·        Drugs that increase bone formation and prevent destruction. Ex: Estrogen, strontium ranolide

 Surgical treatment in osteoporosis

The aim is to save the patient from being bedridden and return to normal life. Otherwise, the patient will be lost in a short time due to the heart and circulatory system, respiratory system and other systemic complications. For this reason, fracture treatments that require surgical treatment should be done early. Applications made:

·        Total or partial hip replacement in hip fractures

·        Vertebraplasty or kyphoplasty in vertebral compression fractures

·        Conservative treatment or surgical treatment with internal fixation devices in wrist and shoulder fractures depending on the shape of the fracture.