TUESDAY, Dec. 18 (HealthDay News) -- One bone mineral density test can accurately predict a woman's chance of spinal fractures 15 years down the line, new research shows.

And, according to the largest and longest prospective study of osteoporosis ever, women who had a spinal fracture at the beginning of the study had four times the risk of sustaining another fracture later on.

The bottom line: "Women need to talk to their doctors about the risk of osteoporosis," according to Jane Cauley, lead author of the study and professor of epidemiology at the University of Pittsburgh Graduate School of Public Health.

Her team published the findings in the Dec. 19 issue of the Journal of the American Medical Association.

"I agree with the guidelines that all women after the age of 65 have bone density tests, and Medicare will pay for that," Cauley said. "Women who are postmenopausal, 50 to 64 years of age, should consider having a bone density test if they have other risk factors for osteoporosis or if they want to know what their bone density is before they consider any other treatment."

The findings don't change current standard practice, experts said, and they don't change the basic message to women: Don't ignore bone health, especially in middle and old age.

"The only really major advance here is that it's a longer term study. Mostly studies are five years typically. This one went out 15 years," said Paul Brandt, associate professor of neuroscience and experimental therapeutics at Texas A&M Health Science Center College of Medicine in College Station. "Women need to get their bone mineral density tested after they start menopause and if they stay on hormone replacement therapy or an anti-osteoporotic treatment." he said.

Postmenopausal women are particularly vulnerable to fractures resulting from osteoporosis, a degenerative weakening of the bones. Some 10 million Americans, including one in five American women over the age of 50, suffer from osteoporosis, which is the most common type of bone disease.

Spinal fractures are the most common type of fracture resulting from osteoporosis, affecting 35 percent to 50 percent of women over 50 (about 700,000 vertebral fractures annually in the United States).

But many, if not most, of these fractures go undetected. "Osteoporosis is sometimes called the silent thief," Cauley said. "It basically robs the skeleton of strength and resources, and women don't really know about it. About 75 percent of all spine fractures actually occur silently."

"Identifying risk factors for spine fractures is less well developed. You have to systematically look for them by repeated X-rays," Cauley continued.

The findings from this study are based on bone mineral density data from 2,300 women over the age of 65 who enrolled in the Study of Osteoporotic Fractures (SOF), initiated in 1986.

After 15 years of follow-up, it was evident that 25 percent of women who had low BMD at the beginning of the study developed fractures of the spine, compared with only 9 percent of women with normal BMD.

"It was pretty much a strong gradient of risk," Cauley explained. "If you had normal bone density when you entered and did not have an [existing] fracture, the risk of having a new spine fracture was about 9 percent, compared to a risk of 56 percent in women who had osteoporosis and who had an existing fracture. So, the range of risk varied dramatically depending on bone density and previous spine fractures."

According to Brandt, one interesting finding from the study is that a previous vertebral fracture topped even bone mineral density as a predictor for future fracture.

This indicates that women with an existing vertebral fracture should be treated for osteoporosis regardless of their BMD, the authors reported.

"People think osteoporosis is an inevitable consequence of aging, but it is preventable and treatable," she said.

More information

There's more on age-linked bone loss at the U.S. National Library of Medicine.

FRIDAY, Nov. 30 (HealthDay News) -- Damage to the menisci -- the knees' "shock absorbers" -- is sometimes associated with knee osteoarthritis, but it does not directly provoke pain, aching and stiffness, a U.S. study finds.

"Any association between meniscal damage and frequent knee pain seems to be present because both pain and meniscal damage are related to osteoarthritis, and not because of a direct link between the two," study spokesperson Dr. Martin Englund, of Boston University School of Medicine, said in a prepared statement.

The menisci serve as cushions against joint cartilage degradation where the knee connect with the thigh and shin bones. Loss of meniscal function is a major risk factor for knee osteoarthritis. About 6 percent of middle-aged Americans, and between 11 percent and 15 percent of those aged 65 and older, have knee osteoarthritis.

For this study, researchers looked at people with knees (a total of 110) that had signs of knee osteoarthritis or were at high risk of developing knee osteoarthritis at baseline and developed frequent knee pain, stiffness or aching by the end of 15-month study. They were compared to a control group of people with knees (a total of 220) who had no frequent symptoms at baseline and did not develop any major knee problems during the study.

At the start of the study, meniscal damage was detected in 38 percent of case group knees and 29 percent of control group knees. Meniscal damage was more common in knees that had been operated on or suffered serious injury in the past.

There was a modest association between degree of meniscal damage and the development of frequent knee pain, aching and stiffness, but meniscal damage was most prevalent and pronounced in knees with clear evidence of osteoarthritis.

"Meniscal damage in older adults is highly associated with osteoarthritis of the knee. However, meniscal damage often seems not to be directly responsible for later symptoms, while other features of osteoarthritis may be so," Englund said.

The findings are published in the December issue of Arthritis & Rheumatism.

More information

The American Academy of Family Physicians has more about knee osteoarthritis  .

FRIDAY, Feb. 16 (HealthDay News) -- Delaying having spinal reconstruction surgery to correct spinal deformities such as scoliosis may increase the risk of surgical complications, U.S. researchers say.

Their study found that patients over the age of 69 are about nine times more likely to suffer complications.

"The study shows that waiting too long to have major reconstructive spine surgery can dramatically increase the risk of complications," Dr. Lawrence G. Lenke, an orthopedic spine surgeon and a professor of orthopedic surgery at the Washington University School of Medicine in St. Louis, said in a prepared statement.

"In fact, sometimes waiting too long means the disease state has progressed to a point that would make any kind of surgical solution unsafe," Lenke said.

Researchers evaluated the effect that patient age had on complications and outcomes for major spinal deformity surgeries. They concluded that patients over age 60 have an overall complication rate of 37 percent and a major complication rate of 20 percent.

"We found the major risks associated with complex, multi-level spinal reconstruction in patients 60 to 69 years of age were similar to that of lesser surgeries performed on patients in the same age group," Dr. Michael D. Daubs, an orthopedic spine surgeon and an assistant professor of orthopedic surgery at the University of Utah, said in a prepared statement.

"But after age 69, the risks jump significantly for those having complex procedures, including trunk imbalance correction," Daubs said.

The patients included in this study had suffered spinal deformity-related pain for years and had tried all non-surgical options to manage their pain. Surgery was their last hope.

"The study also shows that patients age 60 and older can benefit from major reconstructive spinal surgery. Patients in our study showed significant functional improvement at the two-year follow-up," Daubs said.

He noted that people with spinal deformities often experience painful degenerative spinal changes in their 40s and 50s, but many of them delay having surgery.

The study was scheduled to be presented on Friday at the American Academy of Orthopaedic Surgeons annual meeting, in San Diego.

More information

The American Academy of Orthopaedic Surgeons has more about scoliosis  .