<- Home <- Arhive <- Vol. 23, Issue 4, December 2015

Rom J Leg Med23(4)265-268(2015)
© Romanian Society of Legal Medicine

Diagnosis of male osteoporosis after severe lumbar trauma

A. Ghemigian, M. Carsote, D. Terzea, C. Capatina

Abstract: Introduction. Primary osteoporosis in men is significantly less frequent than in women but is similarly associated with an increased risk of fractures (including fragility fractures i.e.fractures that occurr without any causal trauma). Vertebrae are common sites for fragility fractures which can be oligo- or completely asymptomatic. Case report. We present the case of a man diagnosed after a traumatic event with both severe spine fractures and agerelated osteoporosis. A 65-year non-smoking Caucasian man with negative medical history suffered a spine trauma during his work in constructions. Fractures at T12 and L1 were diagnosed and surgically managed (T12 laminectomy and T12-L1 bilateral titanium osteosynthesis). Osteoporosis was also confirmed by DXA osteodensitometry. He received antiosteoporotic treatment (bisphosphonates, vitamin D supplementation) but at the 1 year- follow-up visit a new fragility fracture (T7 vertebra) was diagnosed. The occurrence of fragility fractures despite active antiosteoporotic treatment raised significant dillemas related to the individual contributions of osteoporosis and trauma to the initial, apparently posttraumatic vertebral fractures. Conclusion. In the presence of confirmed osteoporosis (a condition with increased risk of spontaneous vertebral fractures, frequently asymptomatic) it is very difficult to correctly discern the contribution of a spinal trauma to the etiopathogenesis of vertebral fractures.
Keywords: primary osteoporosis, vertebral fractures, fracture risk.

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