During the past several years we encountered several elderly women with Osteoporosis of the Spine (EWOS) who lost excess height due to descent of the thoracic cage into the pelvis. These women had a small waistline due to a wide pelvic inlet. We studied 30 females ages 71-93 (mean age =77 years), with a mean weight of 118 pounds who fit this category, and 7 females ages 42-82 (mean age =63), mean weight of 128 pounds, with small waist/wide pelvis, and minimum height loss, who served as controls. EWOS commonly loose only 0.5-1.5 inches of height because the pelvis may block further descent of the thoracic cage. However, we noticed on examination that patients with wide hips and wide pelvic inlet, or a tapered terminal rib cage, allowed more of the thoracic cage to descend into the pelvis before resting against the inside of the pelvis. EWOS with a small waist, wide pelvic inlet, and endopelvic thoracic cage, lost 2-8 inches of height (mean =4.0), developed bladder and bowel problems, dyspnea, pulmonary dysfunction, and problems finding a good position to sleep. Two patients showed restricted pulmonary function test. Controls had the same thoracic cage pelvic anatomy, but only had a 0.5-inch loss of height, ranging from 0 to 1.0 inches, and no systemic symptoms. We conclude that elderly women with a small waist and wide pelvic inlet may develop excessive height loss, and secondary systemic problems, if allowed to develop severe spinal Osteoporosis and that aggressive preventative and or treatment measures, are appropriate for these women.
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