Osteoporosis is a decrease in bone mass that is more common in postmenopausal women. This decrease occurs not only in the mineral (e.g. calcium, phosphorus) components, but also in the so-called organic (e.g. protein) components of the bones. About 15-20 million people suffer from osteoporosis and more than 500,000 people suffer from spinal fractures due to osteoporosis every year. These fractures can occur with minimal or no trauma at all. Symptoms and diagnosis: Low back pain is the most common symptom and x-rays may show wedge or compression fractures of the vertebrae. an MRI or CT scan may be necessary to further evaluate these fractures. A definitive diagnosis of osteoporosis is important because similar symptoms can occur in other conditions such as infections, other metabolic bone diseases, and benign or malignant bone tumors. The degree of osteoporosis can only be estimated by plain X-rays and must be confirmed by specific bone density tests or, in some cases, by bone marrow aspiration biopsy to confirm its presence. Treatment: Fortunately, most spinal fractures caused by osteoporosis can be controlled by medication alone, but once a spinal fracture is confirmed, the underlying osteoporosis must also be addressed. Treatment for osteoporosis itself is rapidly evolving. Calcitonin can be used in some cases to inhibit the breakdown of bone minerals, and fluoride has been done in an attempt to increase bone mass. More recently, drugs from the bisphosphonate family have been used to help maintain bone mass and possibly increase bone mass. In addition to medication, other devices such as braces help control pain and stop the worsening of deformities. Although braces usually do not correct deformities, they can support the spine and may reduce secondary muscle spasm. In rare cases, surgery may be necessary to control pain, improve deformity, or decompress nerve roots or the spinal cord. Newer techniques for treating compressed vertebrae include compression vertebroplasty and vertebral kyphoplasty. In compression vertebroplasty, an osteointegrating agent is injected into the vertebrae to improve bone strength. In kyphoplasty, the bonding agent is injected after the wedge shape has been improved, an inflated balloon is wedged into the vertebrae, and the space is filled with cement. For both procedures, minimal sedation and local anesthesia are required, but sometimes general anesthesia is needed. These procedures can be done with very small incisions under x-ray control. As with any other surgical procedure, there is some risk involved.