Compression Fracture in Postpartum Osteoporosis
A 42-year-old multiparous woman arrived at the emergency room with back pain. One month earlier, she had a tertiary cesarean section and a left ovarian cystectomy. During the cesarean section, there were no other complications. She had breast-fed her baby after delivery. Her height was 159 cm and her weight was 56 kg. She had no other bone anomaly. She did not exercise on a regular basis. She had no past surgical or family histories, nor had trauma. On physical examination, she had diffuse back pain. The pain was so severe that she had difficulty in getting up for 7 days. The lumbar spine anteroposterior (AP) and lateral revealed recent compression fractures of T12, L1, and L3. A bone scan also revealed increased bone uptake, perfusion, and multiple recent compression fractures of T12-S1 (). Bone marrow density determined using dual energy X-ray absorptiometry (DXA) revealed that the T-scores for the lumbar vertebrae L1-L4, femoral neck, and femoral total were significantly low in the patient (). She was given calcium 500 mg daily and a chest brace for non-weight bearing.