Overview of osteoporosis: pathophysiology and determinants of bone strength
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Recent advances in both the pharmacological and surgical treatment of osteoporosis and vertebral compression fractures offer exciting new options for elderly patients. However, these treatments should be considered only with an indepth knowledge of osteoporosis as a metabolic disorder with complex effects on bone, its homeostatic regulation, and vertebral strength. Bone homeostasis is under the influence of both endogenous hormonal changes and external mechanical loads resulting from physical activity. These impart their effects through regulation of the relative activities of bone cells, in particular osteoblasts and osteoclasts, which control bone deposition and resorption, respectively. The strength of a vertebra is directly influenced by the amount and relative proportions of its components, with bone mineral density a useful measure of fracture risk. The purpose of this article is to discuss these issues, among others, in order to offer the reader a better understanding of the pathophysiology of osteoporosis and the determinants of bone strength as they relate to the aging skeleton.
KeywordsOsteoporosis Aging Mechanical effects Pathophysiology
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- 8.Garfin SR, Yuan HA, Reiley MA (2001) New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful ostoeporotic compression fractures. Spine 26:1511–1515Google Scholar
- 9.Gill SS, Einhorn TA (1998) Bone metabolism and metabolic bone disease. In: JH Beaty (eds) Orthopaedic knowledge update 6. American Academy of Orthopaedic Surgeons, Rosemont, pp 149–165Google Scholar
- 13.Lacey DL, Timms E, Tan HL, Kelley MJ, Dunstan CR, Burgess T, Elliott R, Colombero A, Elliott G, Scully S, Hsu H, Sullivan J, Hawkins N, Davy E, Capparell iC, Eli A, Qian YX, Kaufman S, Sarosi I, Shalhoub V, Senaldi G, Guo J, Delaney J, Boyle WJ (1998) Osteoprotegerin ligand is a cytokine that regulates osteoclast differentiation and activation. Cell 93:165–176CrossRefPubMedGoogle Scholar
- 14.Leidig-Bruckner G, Minne HW, Schlaich C, Wagner G, Scheidt-Nave C, Bruckner T, Gebest HJ, Ziegler R (1997) Clinical grading of spinal osteoporosis: quality of life components and spinal deformity in women with chronic low back pain and women with vertebral osteoporosis. J Bone Miner Res 12:663–675PubMedGoogle Scholar
- 19.Silver JJ, Majeska RJ, Einhorn TA (1994) An update on bone cell biology. Curr Opin Orthop 5:50–59Google Scholar
- 21.White A, Panjabi M (1990) Clinical biomechanics of the Spine. Lippincott, PhiladelphiaGoogle Scholar