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Osteopenia and Osteoporosis

Osteopenia is a medical condition where bone mineral density is below normal, but not to the point of developing osteoporosis. Bone mineral density is determined by the dual energy x-ray absorptiometry (DKA, formerly DEXA). The DKA gives a value called a T-score; a T-score of -1.0 or greater is normal, -1 to -2.5 is low bone mass or osteopenia, and -2.5 or below his osteoporosis.

Those at higher risk of developing osteopenia and osteoporosis include:

  • Females over 65
  • Caucasian
  • Slim build
  • Family history of osteoporosis
  • Long-term use of steroids or anticonvulsants
  • Eating disorders or diseases
  • Smoking, inactivity
  • Excessive alcohol intake
  • Diet low in calcium and vitamin D.

Generally, osteoporosis is asymptomatic. The diagnosis is often made after a pathologic fracture occurs. These fractures most commonly involve the wrist, hip and spine. Fractures that occur in these areas are due to the loss of sponge-like bone inside the outer shell of the bone. This loss of spongy bone usually begins at the age of 30 – 35, and occurs to a higher degree with women. These fractures can result in pain, disability, deformity, and early death.

The prevention of osteoporosis requires lifestyle changes. Smoking cessation, moderate alcohol use, weight-bearing exercise, and calcium and vitamin D supplements.

Calcium and vitamin D daily recommendations

Supplementation with other medications, such as by biphosphonates, teriparatide, raloxifene, and denosumab may be required after consultation with your family physician or internist.


Once a spinal fracture occurs, the treatment of the fracture may be the use of a brace, kyphoplasty, vertebroplasty or surgery. After stabilization of the fracture, mobilization, weight-bearing exercise, and medical management are needed. Subsequent safety evaluation and injury prevention strategies are essential to prevent additional injuries.

To learn more about Dr. Cotler or to schedule an appointment, please call us on (713) 523-8884.

Howard B. Cotler, MD, FACS, FAAOS is board certified and recertified in Orthopedic Surgery. He is a fellow of the American Academy of Orthopedic Surgery and the American College of Surgeons.

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