Aetiology

Disc degeneration and osteoporotic wedging of the vertebraePagets may develop increased kyphosis due to bone softeningPathological fractures (osteoporotic or neoplastic)

Clinically

Usually slowly progressive and not painfulMore often seen in osteoporotic femalesMay complain of lumbo-sacral pain due to compensatory lumbar lordosis in order to stand uprightX-RaysIntervertebral discs may indent the soft vertebral bodies which become biconcave

Treatment

Symptomatic with rest and analgesics, walking stick etc to unload the spineRadiotherapy for malignancyCalcitonin for Pagets