Structural consequence of osteoporosis
Rapid bone loss is the result of excessive depth of osteoclastic resorption cavities. This leads in trabecular bone to perforation of structural elements, increased size of marrow cavities, and discontinuity of the bone structure, and in cortical bone to subendosteal cavitation and conversion of the inner third of the cortex
to a trabecularlike structure, which then undergoes the same changes as the trabecular bone originally present. These structural characteristics reduce the strength of the bones to a greater extent than the reduction in the amount of bone by itself would suggest. Slow bone loss results from incomplete refilling by osteoblasts of resorption cavities of normal or reduced size. This leads to simple thinning of residual structural elements in both trabecular and cortical bone, and reduces the strength of the bones in proportion to the reduction in the amount of bone. This concept, although derived mainly from an examination of postmenopausal bone loss, may be applicable to other osteopenic states. At the same time as bone loss is occurring on the endosteal surface, rapidly or slowly, bone is being added to the periosteal surface, but much more slowly than during growth. The cellular mechanism is the converse of that causing slow bone loss, consisting of slight overfilling of shallow resorption cavities. Slow periosteal gain serves to partly offset the structural weakness resulting from endosteal loss, but is not directly compensatory.
Functional consequence of osteoporosis
Osteoporosis is often called a "silent disease." You can't feel or see your bones getting thinner.
A broken bone in your spine is called a vertebral
fracture. It is the most common break that occurs as a result of osteoporosis. A spine fracture may affect many parts of your body, besides the broken bone itself. Fractures of the spine can cause loss of height, a curving of the shoulders and back, and a thickening waistline. Sometimes back pain
occurs. Depending on the location and severity of the spinal fractures, individuals may experience difficulty breathing
and stomach pain or digestive discomfort. In the year following a spine fracture, almost 20% of women will experience another spine fracture. Broken bones in the wrist, arm, leg, pelvis or ribs can cause substantial pain and temporary disability
. Surgery, casting or splinting may be required.
The worst consequences of osteoporosis can happen after a hip fracture
. Hip fractures most often occur in adults over the age of 70. Almost all people who have hip fractures require surgery to repair the broken bone. A broken hip may lead to a loss of independence. Following surgery, it is common for individuals to need help from family, friends or healthcare professionals with daily activities such as bathing, dressing and shopping. Complications from surgery can be serious.
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