脊柱骨质疏松压缩性骨折的手术治疗PPT课件

may be sacrificed to satisfy the body's intra- and extracellular calcium needs.
The Progression of Bone Remodeling
A specific quantity of bone is resorbed from the remodeling site and then a reversal occurs and the cavity is occupied by osteoblasts which refill that cavity with bone
bone loss is equal increased number of
to bone formation remodeling sites
and the amount of increased porosity
bone tissue present of the bone, ie the
represents normal remodeling space,
Therefore, fractures related to osteoporosis most commonly occur in areas rich in cancellous bone (ie, the vertebrae and wrist), and BMD measurements have focused on these critical anatomic sites
menopause women begin a period of accelerated bone loss, averaging from 2%-5% per year over the next ten years.
Estrogen-Related Bone Loss
although high affinity estrogen receptors have been identified on both osteoclasts and osteoblasts.
of cortical bone.
Bone Loss: Cancellous vs. Cortical Bone
Cancellous bone is more metabolically active than cortical bone.
If bone remodeling becomes uncoupled, with osteoclastic activity exceeding osteoblastic activity, the mass and structural integrity of cancellous bone is more severely affected than cortical bone.
Mechanisms of Bone Loss
An increased number of bone remodeling units can be activated which, when combined with either of the above two processes, may result in increased bone loss.
bone mass
and this gives
decreased bone mas
Bone Loss: Cancellous vs. Cortical Bone
Although cancellous bone may account for less than 25% of the total bone mass in healthy adults, its surface area far exceeds that
SURGICAL TREATMENT OF SPINE
OSTEOPOROSIS
Concept of Osteoporosis
• A systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and a susceptibility to fracture."
high turnover with either increased formation or increased resorption or bothቤተ መጻሕፍቲ ባይዱ
Patterns of Age-Related Bone
Loss
Gradual bone loss begins in both men and women between the age 30 and 40, paralleling an age-related decline in muscle mass.
Additionally, it is thought that estrogen deficiency is more directly associated with accelerated bone loss, but not age-related bone loss.
Bone Loss: Cancellous vs.
Cortical Bone
During the accelerated period of bone loss occurring immediately post-menopause, cancellous bone loss is increased 3-fold, while rates of cortical bone loss are slower.
the above definition developed in Hong Kong in 1993
Pathophysiology of OP
Bone Remodeling • Imbalance of bone remodeling, • In pathologic situations, bone mass