The octopus has been caused a condition of the spine called kyphosis and we have patch abuse Evonik on our 3d image doctor explained to us what causes is and what we’re seeing here absolutely Kathy so we refer to the sagittal balance of the position of the human spine with a view from the side as far as lordosis and kyphosis so for example your lumbar spine normally has a backward band it’s concave to the back and that’s called lordosis now there’s degrees of lordosis and kyphosis therefore if this C curve was less pronounced we would say that it’s kyphotic but really what’s kyphotic is the thoracic spine the middle of the spine which is concave to the front the band is forward flexed that’s Chi forces now imagine if one of these bones was to accordion down and remember that the fractures occur more in the front of the spine than in the back of the spine if you lose the anterior column or the anterior part of the spine in terms of its height then the spine will start to sort of flex forwards exactly and then that will result in what we would perceive clinically as Tai forces now dr. Regalado made a great summary of the risk factors for compression fractures and there’s one that I’d like to add its history of compression fractures frequently we’ll hear patients come in and say I’ve had one two three four different structures that’s a big problem for a healthcare system because it’s really doctors responsibility once you see the first structure to prevent future fractures from happening now look osteoporosis that’s a medical problem it needs to be addressed by proper diagnostic tests to know the degree and then it needs to be addressed with proper medicines therefore we can prevent progression fractures or new fractures were happening you