Post Pregnancy Severe Spinal Osteoporosis with Multiple Vertebral Fractures and Kyphoscoliosis in a Multigravida: A Rare Case with Management

Osteoporosis associated with pregnancy and lactation is a less commonly known condition and often overlooked. The prevalence, exact aetiology and its pathogenesis are unknown. It is commonly seen in first three months after delivery in primigravida. It is often undiagnosed because of it not suspecte...

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Published in:Asian spine journal 2015, 9(4), , pp.625-628
Main Authors: Hadgaonkar, Shailesh, Shah, Kunal Chandrakant, Bhatt, Hrutvij, Shyam, Ashok, Sancheti, Parag
Format: Article
Language:English
Subjects:
Back pain
Bisphosphonates
Bone density
Breastfeeding & lactation
Case Report
Case reports
Compression
Conflicts of interest
Densitometry
Developing countries
Fractures
Infants
Kyphosis
Lactation
LDCs
Osteoporosis
Parathyroid hormone
Phosphatase
Post-pregnancy
Postpartum period
Pregnancy
Risk factors
Scoliosis
Socioeconomic factors
Spinal fractures
Spine (lumbar)
Teriparatide
Tomography
Vertebrae
Vitamin D
Weaning
정형외과학
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Summary:Osteoporosis associated with pregnancy and lactation is a less commonly known condition and often overlooked. The prevalence, exact aetiology and its pathogenesis are unknown. It is commonly seen in first three months after delivery in primigravida. It is often undiagnosed because of it not suspected n and X-rays and densitometry are avoided if possible during pregnancy and lactation. If missed, it can lead to osteoporotic fractures and disability. In this paper, we report a case of a 24-year-old multigravida 4 months after pregnancy with multiple vertebral compression fractures and kyphoscoliosis. Her metabolic workup was normal but bone densitometry revealed severe osteoporosis of the dorso-lumbar spine. Immediate weaning and antiresorptives like bisphosphonates and teriparatide are used as first line drugs to manage postpartum spinal osteoporosis. Our patient presented at 4 month lactation and did not want to wean her infant, so she was treated with total contact orthosis and took vitamin D and calcium. The pain was relieved within 3 months but there was no improvement in bone density. After eight months when the infant was weaned, she was treated with teriparatide. After one year of teriparatide therapy, there were no new fractures and densitometry scores improved.
ISSN:1976-1902
1976-7846
DOI:10.4184/asj.2015.9.4.625