Osteoporosis: a review.

Osteoporosis is the most common metabolic bone disorder and remains an increasingly significant problem, affecting 200 million individuals worldwide. Osteoporosis often is undertreated and underrecognized, in part because it is a clinically silent disease until it manifests in the form of fracture. Sufficient recognition of the disease and its appropriate medical and nonmedical treatment are essential. Treatments including calcium and vitamin D, the bisphosphonates, estrogen, selective estrogen receptor modulators, calcitonin, parathyroid hormone, balance and exercise training programs, and the minimally invasive spine procedures vertebroplasty and kyphoplasty comprise a comprehensive multidisciplinary approach in the treatment of osteoporosis. The data suggest that medical treatment of osteoporosis is increasing each year as physician awareness is heightened. Nonmedical treatment of osteoporosis complements the appropriate pharmacologic treatment, and these treatments should be used together to maximize outcomes for patients with osteoporosis. Fracture data for the intravenous biphosphonates and the long-term effects of the minimally-invasive spine procedures vertebroplasty and kyphoplasty have yet to be reported in the literature, but the effects on bone mineral density, and short-term results of these procedures, respectively, have been promising.