Osteogenesis imperfecta

The phrase osteogenesis imperfecta may look like a mouthful, but there's a chance you may be familiar with this condition under a different name.

Osteogenesis imperfecta (OI) is commonly known as brittle bone disease: a genetic condition that prevents adequate production of collagen, resulting in under-developed bones that are naturally more susceptible to fractures.

According to the Osteogenesis Imperfecta Foundation, osteoporosis is an almost universal consequence of this (learn about osteoporosis here). Sadly, it's not the only possible consequence that people with OI sometimes have to deal with.

 

The relationship between osteogenesis imperfecta and scoliosis

While the likelihood of being diagnosed with both osteogenesis imperfecta and scoliosis is extremely rare (0.1 in a million), it's far from an impossibility. In fact, many within the medical community theorise that there is a relationship between the two conditions.

It's believed by some medical professionals that OI can actively contribute to the development of scoliosis. As such, the chances of developing scoliosis are, in theory, likely to increase marginally if you already have OI.

 

Scientific studies on OI and scoliosis

Findings presented by James J. McCarthy at the American Academy of Orthopaedic Surgeons' 74th Annual Meeting in 2007 appeared to confirm this theory. The study focused on childhood OI in particular, and was carried out retroactively.

Of the 288 osteogenesis imperfecta patients studied, 83 were later diagnosed with scoliosis. This represented a 28.8% incidence of scoliosis in existing OI sufferers. What's more, those who underwent corrective surgery for their scoliosis had a high rate of complication.

Meanwhile, a further study published in the Journal of the American Academy of Orthopaedic Surgeons in 2017 noted that, while scoliosis is rarely discovered in OI patients under six years old, it can progress rapidly thereafter.

The journal went on to note that the most common type of scoliosis curve found in OI sufferers was a single thoracic curve (present in 97% of scoliosis patients with type I OI). Meanwhile, 58% of scoliosis patients with type III OI had curves in the thoracic region.

Healthy bone vs brittle bone

Treating scoliosis patients with osteogenesis imperfecta

Due to the fragility of OI patients' bones, scoliosis treatment can be tricky. Manoeuvrability may be limited, and stress placed on the bones could prove to be dangerous.

What's more, younger patients may also exhibit confidence issues and lack of trust in treatment providers, particularly if they have suffered multiple bone fractures in the past.

Here at the Scoliosis SOS Clinic, our aim is to provide safe and effective non-surgical treatment for people with scoliosis. For those who also suffer from osteogenesis imperfecta, our ScolioGold programme is a fantastic way of treating the symptoms of scoliosis without aggravating the symptoms of OI.

From muscular imbalance and trunk rotation to breathing and posture improvement, our specialist treatment courses (led by trained professionals) can be truly life-changing for those who have both OI and scoliosis. The treatment can even be modified to involve fun, interactive exercises for younger patients.

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What is osteopenia, and how can it lead to adult degenerative scoliosis?

 
Osteopenia Bones
 
Osteopenia is a condition where the bones of the human body lose some of their density, making them more fragile and leading to an increased risk of fractures. Osteopenia often occurs naturally with age and is particularly common amongst post-menopausal women. However, there are certain things that may make you more susceptible to osteopenia:
  • Excessive drinking
  • Smoking
  • Not getting enough exercise
  • Coeliac disease
  • Low BMI
  • Certain medications
Osteopenia develops gradually and has few symptoms. Many people with osteopenia don't notice the condition at all until a relatively minor impact results in broken bones, and for this reason, most cases are not diagnosed until a fracture occurs.

Osteopenia vs. Osteoporosis: What's the Difference?

If you're familiar with a condition called osteoporosis, all of the above may sound somewhat familiar. Given that both conditions are characterised by a reduction in bone density (usually occurring in later life), you may even be wondering if osteopenia is just another name for osteoporosis.
 
Well, you're half right: osteopenia is really just a milder form of osteoporosis. If you have osteopenia, your bone mass has begun to decrease, but your condition is not severe enough to be called osteoporosis. Osteopenia sometimes progresses to the point of full-blown osteoporosis, but many osteopenia sufferers remain in that transitional stage - not every case of osteopenia develops into a case of osteoporosis.
 
Both osteopenia and osteoporosis are diagnosed using something called a DEXA scan. During a DEXA scan, X-rays are used to analyse your bone mineral density; your results are then compared to a healthy person of your age and sex to find your so-called 'T score'.

What Your T Score Means

  • Higher than -1 SD: You do not have osteopenia or osteoporosis.
  • -1 to -2.5 SD: You do not have osteoporosis, but you may be diagnosed with osteopenia.
  • Lower than -2.5 SD: You have osteoporosis.

Scoliosis Among Osteopenia / Osteoporosis Patients

Reduced bone density means weaker bones, and fractures aren't necessarily the only thing that osteopenia / osteoporosis sufferers have to worry about. A spine that has been weakened by osteopenia is more likely to curve over time, and so osteopenia / osteoporosis patients are more likely to develop adult degenerative scoliosis than people with a healthy bone mineral density.
 
If you suffer from a curvature of the spine - whether it's due to osteoporosis, osteopenia, or other factors entirely - please contact the Scoliosis SOS Clinic today to find out about our effective non-surgical treatment courses. Our helpful team of experts will be happy to help you with your condition. 

While scoliosis usually starts to develop during puberty, it is not unheard of for the condition to arise far later in life. We frequently treat elderly scoliosis sufferers here at the Scoliosis SOS Clinic, and whereas our younger patients usually have what's known as idiopathic scoliosis (a progressive spinal curvature with no apparent cause), scoliosis in older people almost always occurs as the result of another, underlying condition.

Very often, that underlying condition is osteoporosis.
 
Osteoporosis vs. Normal Bone Density

What is osteoporosis?

Osteoporosis is a weakening of the bones that commonly occurs in later life. As we age, our bones naturally lose mass and become more fragile, although this process happens more quickly in some people than others. You are particularly at risk of osteoporosis if:
  • You are going through, or have already experienced, the menopause (reduced oestrogen levels often lead to a rapid decrease in bone mass, particularly when the menopause occurs before the age of 45)
  • You have a very low BMI
  • You drink and/or smoke heavily
  • You don't get enough calcium and vitamin D in your diet
  • Osteoporosis runs in your family
  • You don't get enough exercise
  • You have had your ovaries removed (e.g. due to ovarian cancer)
  • You have been taking certain medications (such as corticosteroids) for an extended period of time

Symptoms of osteoporosis

Osteoporosis doesn't have any symptoms in and of itself, but it is problematic because weak bones are far easier to break. Reduced bone mass can easily be identified via an X-ray or DEXA bone mineral density scan; however, many osteoporosis sufferers remain unaware of their condition until they break a bone (usually a hip, wrist, rib or vertebra).
 
Increased risk of fracture isn't the only issue that can arise due to osteoporosis. When the bones in the spine lose their strength and density, the spine can begin to slip into a curved position as it becomes too weak to support the weight of your upper body. This is how many osteoporosis sufferers end up suffering from hyperkyphosis (a forward curvature of the spine) or scoliosis (a sideways curvature of the spine).
 
Osteoporosis & Curvature of the Spine

Treating osteoporosis and osteoporosis-related scoliosis

Once osteoporosis has been diagnosed - and again, this often doesn't happen until after the patient has suffered a fracture - the condition can sometimes be managed using medication that helps to strengthen the patient's bones. Doctors may also recommend dietary/lifestyle changes to help slow the deterioration of the bones, and certain measures can be taken to reduce the risk of a fracture (e.g. removing household hazards that may result in a fall).
 
When scoliosis arises as the result of osteoporosis, it can be treated in a number of different ways. Some patients will undergo surgery to correct their spinal curvature, but it is usually possible to manage the condition with physical therapy - eliminating the need for surgical intervention.
 
Located in the City of London, the Scoliosis SOS Clinic treats scoliosis and hyperkyphosis sufferers using the ScolioGold method (a combination of specially selected non-surgical treatment techniques). Click here to see the results that this approach can achieve for elderly patients, or contact Scoliosis SOS now to arrange a consultation.