Colorado Center for Bone Research

The Colorado Center for Bone Research at Panorama Orthopedics & Spine Center is highly regarded as one of the world’s leading authorities on Osteoporosis and other rare metabolic bone diseases, including but not limited to: Paget’s disease; kidney bone disease; osteogenesis imperfecta; adult hypophosphatasia; kidney stones; primary hyperparathyroidism; hypoparathyroidism; and atypical lower extremity fractures in young people and those on bisphosphonates. The Colorado Center for Bone Research delivers exceptional care for patients so that they may lead happier, stronger and healthier lives.

The Colorado Center for Bone Research has an approach and care philosophy that rests on three tenets: prevention, diagnosis and treatment. Our goal is to evaluate patients at an early stage to prevent complications of osteoporosis. We also employ top technologies to measure bone density to evaluate our patients.

Our providers personally read all patients’ bone scans to ensure proper diagnosis and management advice.

Finally, Colorado Center for Bone Research patients are provided the most current treatments and medications, as well as, access to resources and information on nutrition, exercise and drug therapies – all with the intent to improve our patients’ quality of life.

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In addition to treating our patients, we are committed to advancing the treatment of metabolic bone diseases. We participate in national and international clinical drug trials that enhance the care of our patients now and for generations to come. CCBR has been conducting clinical trials since 1987, and has established a track record for excellence in evaluating new drug therapies and treatment options. It is because of this excellence that the Colorado Center for Bone Research at Panorama Orthopedics & Spine Center is on the leading edge of developmental treatments for metabolic bone diseases.

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The Team at Colorado Center for Bone Research

Dr Irinel Stanciu, MD, FACE, CCD is new to the Colorado Center for Bone Research, but is not new to metabolic bone disease. She is a board-certified endocrinologist who specializes in osteoporosis, hyperparathyroidism and metabolic bone disorders.

Dr. Stanciu has training in general surgery, internal medicine and endocrinology. She has worked as both an internal medicine and endocrine physician giving her a broad spectrum of experience with endocrine disorders and general health. Dr. Stanciu joins the Colorado Center for Bone Research at Panorama from St. Luke’s Clinic Idaho Endocrinology in Boise Idaho where she was considered the authority on metabolic bone and endocrine disorders.

She joined CCBR in order to care for patients and further the research in metabolic bone disease. She treats every patient individually and uniquely.

More About Dr. Stanciu

Dr Stanciu works closely with her Physician Assistant, Sara Brown. Sara has been a PA for more than twenty years. She grew up in southern Illinois. She attended PA school at Southern Illinois University in Carbondale, Illinois. Sara always had a strong interest in medicine and prior to becoming a PA, she taught anatomy at the undergraduate and graduate level, to include SIU Medical School. She became a PA to be part of the medical team providing patient care. Sara wants to share her knowledge with patients to help them live healthier lives. As a PA, Sara has worked in many different medical specialities including: Family Practice, Urgent Care, Orthopedics and now Metabolic Bone Disease. She is certified in clinical densitometry and is qualified to interpret DXA scans. Her passion is preventative medicine where she can help patients live a healthy lifestyle and make choices to prolong their quality of life.

A Top Research Site

The Colorado Center for Bone Research is a highly sought-after research site, not only do we treat patients with metabolic bone diseases as they progress through the different stages of their recovery toward an active life, but we also research new ways to help treat and in the future cure these ailments. Our providers are the principal investigators for many major clinical drug trials centered around medications to treat osteoporosis. We work with companies in both the United States, Europe and Australia to help develop and test newest cutting-edge medications that can help strengthen and improve the bone microarchitecture as well as new ways to evaluate risk for fracture.

With the insight from various clinical trials, we treat each patient with the best evidence-based medicine and clinical experience in an effort to individualize each treatment according to the patient’s needs and risk. Dr. Stanciu and her team uses the following FDA-approved medications for osteoporosis treatment:

New anabolic agents that help stimulate bone formation, improve bone quality and help heal fractures while reducing further fracture risk in both men and woman: Forteo (teriparatide), Tymlos (abaloparatide), Evenity (romosozumab).
Anti-resorptive medications which help slow the breakdown of bone tissue.
- Calcitonins which are hormones that help build bone density of the spine.
- Bisphosphonates which help slow the breakdown of bone by acting on the osteoclast, reducing bone turnover and in this way, reduces risk of vertebral and nonvertebral fractures and increases the bone density at spine and hip.
- Denosumab – a potent antiresorptive agent that reduces bone turnover using a different metabolic pathway. Its action is short in comparison with bisphosphonates and can be used in patients with chronic kidney disease.

When a new patient presents to CCBR clinic, our providers first look for secondary causes for osteoporosis through laboratory evaluation (blood and urine) as well as radiologic studies.

For example, our providers will order DXA scan with trabecular bone scores (TBS) to quantify the risk for fracture as well as a lateral vertebral assessment for identifying any asymptomatic vertebral fracture. These procedures are all performed right at Panorama Orthopedics & Spine Center’s Imaging Center.

In order to improve the field of metabolic bone disease treatment, we work with the National Osteoporosis Foundation, American Bone Health, and many other foundations and publications to maintain national and worldwide reference databases.

Our physicians, through their extensive research are able to offer solutions to symptoms, as well as, monitor the progress of each patient’s disease. We specialize in the research, diagnosis and treatment of the following metabolic bone diseases:

Osteopenia and Osteoporosis
Paget’s Disease: bone regenerates more quickly and leads to weak and misshapen bones
Rare Bone Disorders
- Tumor Induced Osteomalacia (Oncogenic Osteomalacia): Difficult to locate tumors exist that produce FGF23 a hormone which impairs phosphate reabsorption and leads to soft bone, pain, weakness and fractures.
- Hypophosphatasia: Genetic disease that affects the mineralization of bones and teeth, causes soft bones due to poor bone mineralization.
- Osteogenesis Imperfecta – Genetic disorder – due to defective collagen formation, bones break easily.
Atypical Femur Fractures: due to extended exposure to bisphosphonates there exists reduced bone formation and increased fracture risk
Osteomalacia (rickets, adult rickets): softening of bones usually due to severe vitamin D deficiency
Hypoparathyroidism: Low level of parathyroid hormone leads to decreased calcium and increased phosphorous levels in blood
Hyperparathyroidism: Converse to hypoparathyroidism, the hormone that regulates the calcium and phosphorus levels in blood is overproduced leads to illness, fragile bones, kidney stones, etc.

Our Colorado Center for Bone Research team is the perfect complement to the work done by the Orthopedic team at Panorama Orthopedics & Spine Center. Patients who have fractures that are not healing, spontaneous fractures or fractures related to osteoporosis are now able to benefit from the expertise of the Colorado Center for Bone Research. Our expertise and access to the newest clinical drug trials allow patients to receive the most advanced and complete treatment for their condition.

See Our Current Research Studies

Video Resources

Learning about Osteoporosis with Dr Stanciu

Who Should Consider Seeing A Specialist in Bone Health?

Dr Stanciu Discusses How To Determine the Strength of the Bone

Calcium & Vitamin D for Heathy Bones

The importance of Blood Tests to Understand Osteoporosis

The Fracture Clinic Evaluates Why You Had a Broken Bone

Medications Used to Treat Osteoporosis

Estrogen Therapy to Maintain Bone Health

Learning About Osteoporosis Treatment with Tymlos or Forteo

How to take Biophosphonate Medications for Osteoporosis

Dr Stanciu discusses Prolia for Osteoporosis

Bone Wellness

The Fracture Prevention Clinic

As a part of the Colorado Center for Bone Research, we offer a Fracture Prevention Clinic. Through this program we help individuals who have suffered from a fragility fracture, commonly in the hip, spine or wrist, to assess their bone health and create a treatment program to create stronger and healthy bones so that they may avoid any additional fractures in the future.

Dr. Stanciu and physician assistant, Sara Brown have patterned this program after the leading bone institutes in the country. Learn more about this unique program.

Fracture Prevention Clinic

Patient Care and Recommendations

Our providers are a strong advocates for an overall healthy lifestyle to help manage, prevent, and treat metabolic bone diseases. The Colorado Center for Bone Research at Panorama Orthopedics & Spine Center is a central resource for patients to learn more about changing their lifestyles to have healthier bones. As bone ages it changes and with those changes, people are at a higher risk for fractures – the number one cause of fractures is falls. Our physicians have, therefore, created the following suggestions and materials for his patients to understand how to create a more bone friendly lifestyle, it is our hope that these materials will help you feel better and do more.

What is Osteoporosis?

Osteoporosis is the most common bone disease in humans and it literally means “porous bones.” It is characterized by decreased bone strength and an increased susceptibility to fractures. Bone strength is a measurement of your bone density and bone quality. The clinical diagnosis of osteoporosis is made when an individual falls from standing height and sustains a fracture.

A DXA scan is the standard test to measure bone density and bone health. Colorado Center for Bone Research has two DXA’s on-site at Panorama Orthopedics & Spine Center (one from each manufacturer of DXA machines, since the two machines can give different results.) This test is simple and painless and can assess the health of the bones.

The World Health Organization’s technical definition of osteoporosis is when bone mineral density (BMD) is less than or equal to -2.5 or greater at the hip or spine, as measured by a DXA scan.

This value is termed a T-score. Osteopenia, the precursor for osteoporosis is defined as “low bone mass,” in which the patients T-score is between -1.0 and -2.5. A normal T-score is defined as being above -1.0. Always talk with your doctor to discuss and interpret your results.

Additional information may be found at The National Osteoporosis Foundation website.

To learn more about osteoporosis, osteopenia, and other bone health, please consult these resources

Nutrition for Strong Bones

Your diet and the foods you eat affect your bone health. You can greatly improve your health by incorporating foods and supplements that build bone strength so that they will support you throughout your life.

A healthy diet for healthy bones means a diet that includes 50-75% fresh vegetables and fruits, grown in a sustainable manner, and a predominance of green vegetables and berries. A plant based diet is not only less inflammatory for the cardiovascular and gastrointestinal systems, but is excellent for bones.

The key players in your diet for bone health are calcium and vitamin D. These are essential nutrients for building bone density and healthy teeth. Because your body can’t manufacture its own calcium, getting it from your food and drinks is important. But a lot of patients forget that we can find calcium not only in animal milk products but also in plant-based milk, yogurts and cheeses.

Our physicians recommend obtaining calcium as much as possible from dietary sources and use calcium supplements as needed. An adult patient over age 40-50 that does not have gastrointestinal disorders or surgeries, needs ~ 1200 mg calcium (divided in 2-3 meals/day). More calcium will not reduce risk for fractures or make bones stronger but will increase the risk for kidney stones.

It is in recent years that research has shown the importance of vitamin D levels and the role they play in allowing the body to absorb the calcium. Recent data shows that many people are vitamin D deficient even when they are getting regular sunlight exposure and drinking milk. Men and women alike need both calcium and vitamin D to maintain strong bones.

Our providers may also suggest that patients increase their vitamin D intake above the National Recommended Allowance due to the growing evidence that suggests it can benefit overall health having higher vitamin D levels than the minimum level necessary for calcium absorption.

Our providers have provided more information on nutrition for strong bones. Please review the following resources to help you better understand the role calcium plays in bone health.

Exercise and Fall Prevention

Exercise doesn’t require new clothes or expensive equipment. You can walk the dog more often, park farther away from the store, find a friend to exercise with you and increase your exercise tolerance gradually. Aerobic exercise is one that gets the heart beating faster than normal and keeps that rate for 20 minutes. Some exercises are better than other for your bones.

At Colorado Center for Bone Research we recommend that patients practice gentle yoga, pilates and other exercise programs aimed at improving bone density, flexibility, posture, balance, skeletal alignment, aerobic fitness and muscle size.

In addition to exercise, preventing falls is important for any one with osteopenia or osteoporosis. A person with osteoporosis is more susceptible to a fracture when a fall occurs, especially in the hip, spine or wrist. Consider that nine out of 10 hip fractures in older Americans are the result of a fall.

Our providers have provided several resources to help you learn more about exercise and fall prevention.

Osteoporosis Medications

There is no cure for osteoporosis, but there are steps you can take to prevent, stop or slow its progress. In some cases, with some of the new medications available today, you may even be able to improve bone density and reverse the disorder to some degree.

Getting enough calcium and vitamin D, as well as, appropriate exercise are essential to the bone health of everyone. This includes people treated with an osteoporosis medication.Our providers specialize in finding the right blend of lifestyle modifications and medications to keep your bone health at an optimal level.

Today, thanks to clinical drug trials, we are fortunate to have many new advancements in the medications available to treat osteoporosis and strengthen bones. There are two distinct categories of medications that are used at the Colorado Center for Bone Research:

Antiresorptive agents also known as the bone strengtheners are the medications available that can help to make the bones stronger – some of the drugs in this category include Fosamax, Bonita or Evista.
Anabolic agents – this is the newest class of medications that are available to help grow new bone and strengthen the bones