1. My STEAM project covers the course objective “classify fractures”. Specifically, my project shows and discusses the connection of osteoporosis and vertebral compression fractures. Osteoporosis is a disease characterized by a decrease in bone density (mass). Osteoporosis is caused by the rate of bone formation unable to keep up with the rate of bone resorption. The decreased bone density leads to weaker, more brittle bones that are unable to withstand daily activities. It is projected that around 44 million Americans have been diagnosed with osteoporosis (Alexandru & So, 2012). The most common cause of VCFs (vertebral compression fractures) is osteoporosis. VCFs are very common and 1.5 million are reported annually within the U.S. 25% of all postmenopausal women will acquire a VCF in their lifetime (Alexandru & So, 2012). This is due to lack of estrogen leading to a decrease in osteoblastic activity. Men over the age of 65 are also at risk of VCFs, but are less likely to acquire one than postmenopausal women. After an individual sustains one VCF, they are much more likely to develop at least one more within the future.
    Wedge, biconcave, and crush are the three types of VCFs. Wedge compression fractures are the most common at 50% of all VCFs. These fractures are categorized by compression of the anterior portion of the vertebral body and occur within the midthoracic region (Alexandru & So, 2012). Biconcave fractures are second most common at 17% of VCFs. These fractures show the middle most portion of the vertebral body compressed and the anterior and posterior areas are unaffected (Alexandru & So, 2012). Crush compression fractures are the least common of vertebral compression fractures and account for 13% of all VCFs. These are categorized by the entire vertebral body including anterior and posterior margins being collapsed. The last 20% of VCFs are made up of complex fractures (Alexandru & So, 2012).
    Sudden onset of back pain is the most common symptom of vertebral compression fractures. Increased pain while walking or standing and decreased pain while lying down are common reports among people with VCFs (Tanna & Ong, 2022). Neurologic symptoms are less common due to the fractures most commonly only affecting the vertebral body. Patients with severe osteoporosis can gain VCFs by tossing in bed or sneezing and coughing. It is suggested that 30% of VCFs within patients with severe osteoporosis occur when the patient is in bed (Tanna & Ong, 2022). This demonstrates the extreme risk and commonality of VCFs within patients dealing with severe osteoporosis. Individuals with moderate Osteoporosis can obtain a VCF by falling on the ice. Younger individuals or patients with normal bone density usually have a major injury to cause these fractures, like a serious MVA or skiing accident. Multiple or chronic VCFs can result in kyphosis and loss of height and stature.
    There are some treatments for VCFs and osteoporosis. Given age, acute vs. chronic fracture and pain scale, treatment options can differ. NSAIDS (non-steroidal anti-inflammatory drugs) are the first line of pain medications used for these fractures. Medications for pain in VCFs are titrated-up, from NSAIDS to stronger medications like opioids, of course this is determined case by case (Tanna & Ong, 2022). The WHO analgesic step ladder is used for this. VCFs are most commonly the most painful immediately after fracture. Back braces (TLSO and LSO) can be dispensed by healthcare providers to provide extra stability and reduce pain in patients suffering from these fractures. Patients with osteoporosis should begin medications like bisphosphonates. These medications help moderate the loss of bone density. Helping restore bone density can lead to decreased risk of VCFs. Vitamin D and Calcium can be taken supplementally (Tanna & Ong, 2022). Surgical treatments are also available for VCFs. Percutaneous vertebroplasty is a surgical procedure in which a fractured vertebrae is injected with acrylic cement, under radiological guidance (School of Health and Related Research technology [ScHARR], 2011). Another surgical procedure for VCFs is percutaneous balloon kyphoplasty, where a balloon-like device is inflated within the vertebral body until it reaches optimal height, then bone cement is injected. The aim of these procedures are to stabilize the fractured vertebrae and provide pain relief (ScHARR, 2011).
    I used hand embroidery for my STEAM project. My project demonstrates two different spinal columns affected by compression fractures, shown in red thread. The blue stripes demonstrate the intervertebral discs. The small light brown dots/knots in both pieces demonstrate the bone density. The spine on the left has smaller/ less knots and shows normal bone density, the bone matrix is strong and has high density. The spine on the right has larger /more knots, demonstrating the decrease in bone density and health, this is the osteoporotic spine. The Spine on the right has more VCFs, which are much more severe than the normal spine on the left. This is to show the higher risk and increased severity of VCFs in individuals with osteoporosis.

    Maddie Redinger
  2. Your project looks incredible Maddie! I can tell that you put in a ton of effort and time, so great work. Osteoporosis is a serious health issue that many millions of Americans face. Your project does a fantastic job displaying vertebral compression fractures in an osteoporotic bone.

    When a bone has lost the majority of its bone mass, it becomes porous leaving it susceptible to more compound fractures from shock. Originally, bone is spongy, as it allows for an absorption of the shock. There are many types of fractures: compression, bioconcave, and crush compression ordered from most to least common. You stated sudden onset back pain was a tell-tale sign of a compression fracture, couple with relief when lying down.

    While osteoporosis is hereditary, measures can be taken to reduce risk. A diet filled with healthy calcium, weight-bearing exercise, and nutrient-dense foods are three sure ways to reduce the risk of the disease.

    Great work, again! Thank you for the response on my project.

    Taylor Beam

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