Bono Christopher M, Einhorn Thomas A
Department of Orthopaedic Surgery, Boston University Medical Center, 850 Harrison Avenue, Dowling 2 North, MA 02118, Boston, USA.
Eur Spine J. 2003 Oct;12 Suppl 2(Suppl 2):S90-6. doi: 10.1007/s00586-003-0603-2. Epub 2003 Sep 12.
Recent advances in both the pharmacological and surgical treatment of osteoporosis and vertebral compression fractures offer exciting new options for elderly patients. However, these treatments should be considered only with an indepth knowledge of osteoporosis as a metabolic disorder with complex effects on bone, its homeostatic regulation, and vertebral strength. Bone homeostasis is under the influence of both endogenous hormonal changes and external mechanical loads resulting from physical activity. These impart their effects through regulation of the relative activities of bone cells, in particular osteoblasts and osteoclasts, which control bone deposition and resorption, respectively. The strength of a vertebra is directly influenced by the amount and relative proportions of its components, with bone mineral density a useful measure of fracture risk. The purpose of this article is to discuss these issues, among others, in order to offer the reader a better understanding of the pathophysiology of osteoporosis and the determinants of bone strength as they relate to the aging skeleton.
骨质疏松症和椎体压缩骨折的药物及手术治疗方面的最新进展为老年患者提供了令人振奋的新选择。然而，这些治疗方法只有在深入了解骨质疏松症这一对骨骼、其稳态调节及椎体强度有复杂影响的代谢性疾病的情况下才应予以考虑。骨稳态受内源性激素变化和身体活动产生的外部机械负荷的影响。它们通过调节骨细胞（特别是分别控制骨沉积和吸收的成骨细胞和破骨细胞）的相对活性来发挥作用。椎体的强度直接受其组成成分的数量和相对比例影响，骨矿物质密度是骨折风险的一项有用指标。本文旨在讨论这些问题以及其他相关问题，以便让读者更好地理解骨质疏松症的病理生理学以及与衰老骨骼相关的骨强度决定因素。
