Skeleton Pirate
Artist: LindaB
Friday, January 6, 2012
Spinal BMD And Scoliosis
On June 15, 2006, Ioannis P. Pappou, MD et al published a retrospective study entitled “Discordantly High Spinal Bone Mineral Density Values in Patients With Adult Lumbar Scoliosis.” The purposes of this study were: 1) to investigate the validity of bone mineral density measurements with DEXA in patients with adult lumbar scoliosis and 2) to investigate the association between osteoporosis and adult lumbar scoliosis.
The study concluded the following:
Cobb’s angle measurements on DEXA scans are reliable and comparable to conventional radiographs.
Spinal BMD values are less valuable for monitoring osteoporosis than hip values in scoliotic patients; an increasing discrepancy with age was noted. Scoliotic patients exhibited discordantly high spinal BMD values, despite significant hip osteoporosis. The discrepancy correlated with aging and curve magnitude.
Scoliosis was common among the osteoporotic population (9.47%). Lumbar scoliosis is a useful clinical marker for osteoporosis, irrespective of scoliosis history and magnitude.
Viable alternatives for osteoporosis evaluation of adult patients with lumbar scoliosis are hip DEXA values, in conjunction with other BMD measurements.
http://journals.lww.com/spinejournal/Abstract/2006/06150/Discordantly_High_Spinal_Bone_Mineral_Density.19.aspx
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Wandering Skeleton
Artist: Joel Hoekstra
Osteoporotic Bone
Source: www.mayoclinic.com
4 comments:
Hello,
I got to your blog from Wheat Belly Blog (I think). Anyway, I am researching how I can keep my osteopenia at bay naturally. I am taking Evista--are you familiar with that or do you have any info source? Evista is more a hormone and was prescribed because I have no family history of breast cancer and other factors, but at 63 yrs. old I would rather handle this in another way. I will be getting the strontium soon, and already have upped my D3 and getting K2 so thanks for the info. I will be reading more of your blog. My doc just says take the Evista and whatever calcium I can cram in, but I am suspicious.
Hi! junkgrl,
Evista (Raloxifene) is in a class of drugs called selective estrogen receptor modulators (SERMs). Evista prevents and treats osteoporosis by mimicking the effects of estrogen to increase bone density.
www.nlm.nih.gov
This government website includes a boxed warning on Raloxifene: “Taking raloxifene may increase the risk that you will develop a blood clot in your legs or lungs.”
http://courses.washington.edu/bonephys/opserm.html
This website lists the following major harmful effects:
More venous thrombosis
More fatal strokes
More hot flashes
More gallbladder disease
I think you are wise to consider switching to strontium citrate and other supplements. Be sure to use the best sources for each that you can find. I use Doctor’s Best Strontium Bone Maker for my strontium source and take two capsules per day between 9:00 and 10:00 p.m., so that I am taking the strontium several hours away from food and/or other supplements, especially calcium. I usually eat dinner and take a multivitamin from 5:30 to 6:30 p.m.
Thanks so much BoneLady. I have been eating Paleo since December and my health seems to have improved greatly and I have lost weight. I have a regular scheduled bone scan in 2 more years. Just had one after 2 yrs. of Evista and I was neither worse nor better, (whatever that means--that was just what they said on the phone) but I don't have any real figures on what happened so I have to call and get the real lowdown on what the results mean. I see all the result figures of others on the blogs, and I must say, it boggles me a bit. What is the soonest you can ask for a re-scan after starting this new regime do you think? I always hear I am "borderline", but I am slender boned in shape, and had an eating disorder from age 19-31. I always attribute this "borderline" to the bulimia. But who knows. I was normal in my 50's. I have a steep learning curve ahead it seems so I feel I am taking baby steps here and I need to get armed with information to counter the osteoporosis flim flam out there.
Dear junkgrl,
I am glad to hear your health has improved and you have lost weight on the Paleo Diet, but now I understand why your doctor wants you to take "whatever calcium" you "can cram in." The Paleo Diet does not allow dairy products, which are rich in calcium. Be sure you are getting at least 1200 mg calcium per day from a combination of food and supplements.
People diagnosed with osteopenia or osteoporosis usually get DXA scans every two years because most insurance plans will not pay for more frequent scans. Yearly scans are not necessary anyway because changes to BMD occur slowly. However, if you start on a new treatment plan, such as strontium, and want to see how you are progressing, you could ask for a DXA scan after one year, but no earlier, and you may have to pay out of pocket.
If your last DXA scan after two years on Evista showed you were "neither worse nor better," it means your bone mineral density (BMD) did not change significantly. Some doctors may interpret this as a positive sign. When you call the doctor back, have his office send you a copy of your DXA scans or tell the office staff you will pick the scans up yourself. Pay attention to the numbers, especially your BMD in gm/cm2 at each site (spine, hip, femoral neck) and compare the numbers to the previous scan.
I wish you much luck.
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