| Pregnancy and lactation associated osteoporosis (PLO) is a rare disease, mainly occurring in women at late pregnancy and early postpartum. It always occurs in the first pregnancy. The multiple compression fractures of the thoracolumbar spine are most common, mainly manifested as low back pain, reduced height and limited mobility. Its pathogenesis is still unclear, and may be related to pregnancy, lactation and genetic factors. During pregnancy, the absorption of calcium in the intestine is doubled to meet the needs of fetuses and mothers for calcium. However, if mothers’ calcium intake is insufficient to meet the comprehensive needs of the mothers and fetuses, the mothers’ bone will stimulate bone absorption through parathyroid hormone-related peptide (PTHrP). During lactation, under the leading role of high PTHrP level and the combined effect of low estrogen, bone absorption is promoted and bone calcium is mobilized into the blood. At present, there is no unified diagnostic standard for PLO, and the prevention and treatment measures are still uncertain. Existing studies have shown that the bone mass of most PLO patients increases gradually after weaning. Therefore, for PLO patients, it is recommended to stop breastfeeding and supplement adequate calcium and vitamin D. Anti-osteoporosis drugs such as bisphosphonate, denosumab and teriparatide have been reported to be used to treat PLO. However, its existing or potential side effects limit the use. The overall efficacy of vertebroplasty and kyphoplasty in the treatment of postpartum vertebral fractures is still not clear, so they are generally not recommended. For PLO patients, their conditions should be fully evaluated and treatment plan should be carefully chosen. |