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Suggest Treatment For Brittle Vertebrae
Question: Dr. trying to understand in simple terms what options there may be for my elderly mother. She is in her mid 70s, past cancer survivor with a partial lung removed, 90% of time on O2, but real issue last few years have been breaks in back. her back has broke 5 separate times each required surgery / fusion. just yesterday had surgery for 2 breaks, and news past onto me was probably more will happen but probably no longer a candidate for surgery. when breaks happen she is in extreme pain. so question is what are choices. she live alone, will not move, had been very active in her life
Brief Answer:
Discussion follows
Detailed Answer:
Hello,
Welcome and thanks or your query.
Appreciate your concern for your mother.
She has very frail bones that are breaking. Is it with falls or without?
If it is with falls, every effort should be made to detect the cause like decreased blood flow to the brain, poor vision, unsteadiness etc and try to correct them and in addition use walker to prevent falls.
She probably has osteopenia and low vitamin D. These can be checked and treated.
Take Care
Discussion follows
Detailed Answer:
Hello,
Welcome and thanks or your query.
Appreciate your concern for your mother.
She has very frail bones that are breaking. Is it with falls or without?
If it is with falls, every effort should be made to detect the cause like decreased blood flow to the brain, poor vision, unsteadiness etc and try to correct them and in addition use walker to prevent falls.
She probably has osteopenia and low vitamin D. These can be checked and treated.
Take Care
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
no falls on any breaks, my concern is not why this is happening that's clear very brittle vertebrae. what I don't understand is why at a certain point can they no longer fuse, repair? and what happens then at next break when a Dr won't do surgery. does she just live in extreme pain?
Brief Answer:
Medical management if surgery is not possible
Detailed Answer:
Has the cause for the brittle vertebrae like vitamin D deficiency or osteoporosis been investigated?
If there is osteoporosis alendronate may help and if Vitamin D is low then it can be replaced, both with calcium supplements in addition and hopefully prevent the breaks due to brittle bones.
The surgeon may have mentioned that no further surgery is possible due to technical difficulties or due to high risk due to your mother's health and the oxygen insufficiency.
If the surgeon does not operate she has to be on medical management with. Analgesics, Gabapentin, tricyclics all help alleviate discomfort.
Her vertebrae may be immobilised with braces / external fixators to promote healing.
Medical management if surgery is not possible
Detailed Answer:
Has the cause for the brittle vertebrae like vitamin D deficiency or osteoporosis been investigated?
If there is osteoporosis alendronate may help and if Vitamin D is low then it can be replaced, both with calcium supplements in addition and hopefully prevent the breaks due to brittle bones.
The surgeon may have mentioned that no further surgery is possible due to technical difficulties or due to high risk due to your mother's health and the oxygen insufficiency.
If the surgeon does not operate she has to be on medical management with. Analgesics, Gabapentin, tricyclics all help alleviate discomfort.
Her vertebrae may be immobilised with braces / external fixators to promote healing.
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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