Paget’s Disease of the Spine Explained

Category: Spine | Author: Stefano Sinicropi | Date: June 8, 2017

Paget's Disease of the Spine

If you haven’t heard of Paget’s disease, you’re not alone, which is kind of surprising considering it is the second most common bone disorder in the United States behind osteoporosis. The condition occurs when the cells in your body don’t function properly, which leads to deformed, enlarged or fragile bones. Unfortunately, your spinal vertebra are prone to Paget’s disease. Today, we take a closer look at the condition and explain how it is treated.

What Is Paget’s Disease?

As we mentioned above, Paget’s disease is a condition that is categorized by improperly functioning cells in your body. The condition affects two parts of the bone cell growth process – the osteoblasts or osteoclasts. Osteoclasts are bone cells that work to break down old bone, while osteoblasts help to build new bone in its place. As you can see, if these get out of whack, problems can occur.

When Paget’s disease sets in, your osteoclasts will begin to break down old bone at too fast of a rate. This causes your osteoblasts to work overtime, and this can lead to improper bone growth and deformity. Also, since the bone was created quickly, it is more fragile than healthy bone, which leaves it susceptible to fractures.

The condition typically affects affects individuals over the age of 55, and medical estimates suggest that roughly three percent of individuals over the age of 55 are suffering from Paget’s disease.

Paget’s Disease and Your Spine

If you are diagnosed with Paget’s disease, there’s a good chance the condition will affect your spinal column, as your vertebrae and your pelvis are two areas that are most frequently affected by the condition. Symptoms of the condition include:

  • Pain in the back/neck
  • Dull pain or pain that worsens at night
  • If the condition causes spinal compression, individuals may experience tingling, numbness or gait problems while walking
  • Deformities of the spine

There is no known cause of Paget’s disease, but doctors suspect that genetics play a role in development. The condition isn’t usually caught in an early stage, because patients don’t often experience symptoms until the condition has progressed to a later stage, and since symptoms mimic a number of other spine-related conditions, Paget’s disease isn’t always suspected first.

However, that doesn’t mean the diagnosis will slip by a trained spinal specialist. If you are experiencing symptoms and your doctor wants to rule out the possibility of Paget’s disease, they’ll begin by ordering a round of imaging tests. An x-ray can detect the formation of bone deformities, but it may be more easily diagnosed with a more detailed imaging technique, like a CT scan or MRI. There is also a blood test available that can detect the rate at which your bone cells are being broken down and rebuilt, which is not only helpful during diagnosis, but also during treatment to see if rates are normalizing.

Treating Paget’s Disease

If caught early enough, Paget’s disease can be managed rather easily with medications called bisphosphonates, which normalize the function of the body’s osteoclasts and osteoblasts. However, while they work to normalize function, they do not outright cure the disease, so you’ll need to continue the medications for life and undergo regular monitoring. If the condition was recognized due to a spinal fracture or a spinal deformity, your doctor may also need to surgically correct the spine, and that procedure will depend on your specific condition.

Paget’s disease is manageable, but you’ll want an experienced spinal professional to answer your questions and help you along the way. If you have any questions or think you may have Paget’s disease, reach out to Dr. Sinicropi today.

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