Osteoporosis: new hope for preventing back problems?
This research was completed on 31 December 2007
Published on 7 October 2005
Osteoporosis causes tens of thousands of spinal fractures each year in the UK.1 Often, patients suffer long-term pain as a result of these fractures that is difficult to treat and their backs may become deformed. They even face an increased risk of dying. Researchers are developing a new way to stop these fractures from happening, using a special operation.
What's the problem and who does it affect?
Spinal fractures cause pain and deformity
An estimated seven million people in the UK have osteoporosis.2,3 Their fragile bones break easily. One in two women and one in five men suffer a fracture after the age of 50.2
The most common type of break is where one of the vertebra – the knobbly bones that make up the spine – collapses down on itself. These compression fractures are painful and debilitating. Many people suffer fracture after fracture along their spine, meaning they gradually shrink as they grow older and they get a humped back. Some people find it difficult to walk. They face losing their independence and have an increased risk of falling, breaking other bones and even dying.
Could prevention be the best cure?
Once fractures have happened, many people find conventional treatments such as pain killers and bed rest don't work very well. Drugs can help prevent fractures, but they take a year or more to be effective, a year in which people can suffer further fractures.
What is the project trying to achieve?
Strengthening bones with bone cement might prevent fractures
Researchers think a type of keyhole surgery called vertebroplasty might stop compression fractures from happening in the first place. This involves injecting bone cement into the vertebra to strengthen the bone. The procedure is already used to strengthen broken vertebra.
Researchers think it may prevent fractures in people whose vertebra are weakened by osteoporosis but not yet broken. In this project, researchers will test the procedure in the laboratory using sections of human spines. They will inject the cement and monitor how each section fares, simulating the movements and stresses experienced in two months of day-to-day life using tailor-made apparatus.
Researchers will also design a computer programme that accurately simulates the laboratory experiments on a virtual spine. They will use the programme to find out what affects the long-term success of surgery. Researchers hope to draw up clinical guidelines on how and when to use vertebroplasty to prevent spinal fractures.
What are the researchers' credentials?
|Project Leader||Dr R M Hall|
|Location||School of Mechanical Engineering, University of Leeds|
|Grant awarded||7 July 2005|
|Start date||1 December 2005|
|End date||31 December 2007|
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Since its formation in 1997, the Spinal Biomechanics Research Group at the University of Leeds has rapidly gained an international reputation, particularly in the area of spinal trauma.
Dr Richard Hall has appointments in two departments – Orthopaedic Surgery and Mechanical Engineering – ensuring all researchers take full advantage of this multidisciplinary approach. This project has a strong clinical relevance and the team has access to world class facilities in engineering. Both Dr Richard Hall and Dr Ruth Wilcox have extensive experience of researching innovative treatments for spinal trauma, and both supervise skilled teams of PhD students and research fellows.
The success of this multidisciplinary research group can be measured by the receipt of several international and national awards, including the President's Medal from the British Orthopaedic Research Society in 2001, and the John Moe Basic Science Award from the Scoliosis Research Society in 2000.
Who stands to benefit from this research and how?
Preventive vertebroplasty has great potential for widespread use
If vertebroplasty prevents spinal fractures, this procedure has great potential – it could spare vast numbers of people with osteoporosis from suffering painful and debilitating back problems.
Vertebroplasty is a relatively straightforward operation. It takes just one or two hours, using either a general or local anaesthetic. It requires a minimal stay in hospital, often one night, and little or no rehabilitation. As with any surgery, however, there are risks associated with the procedure.
Sparing people from pain and deformity
Each patient stands to benefit in very important ways. Their pain levels could be greatly reduced. And they could be spared from the deformity and shrinking that osteoporosis causes, because the strengthened vertebra should retain their natural height. The potential cost benefits to the NHS are substantial. Osteoporosis costs the UK more than £1.7 billion per year – that's more than £5 million every day.4 Vertebral compression fractures are the most common complication of osteoporosis and they are set to be an increasing public health burden as the population ages.
1.Secondary prevention of osteoporotic fragility fractures in postmenopausal women – Appraisal Consultation Document. London: National Institute for Clinical Excellence, May 2004 [back to main article] 2.van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone 2001; 29:517-22. [back to main article] 3. Population estimates, Office for National Statistics. Census 2001, Office for National Statistics. Census 2001, General Register Office for Scotland. [back to main article] 4. All Party Parliamentary Osteoporosis Group (APPOG). Falling short: Delivering integrated falls and osteoporosis services in England. December 2004. [back to main article]