Disclosures: The authors report no relevant financial disclosures.
April 16, 2021
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Osteoporosis treatment before spinal fusion may lower risks of complications, revision

Disclosures: The authors report no relevant financial disclosures.
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Preoperative osteoporosis treatment lowered the risks of osteoporosis-related complications and revision surgery in patients undergoing spinal fusion of three levels or more at 1 year, according to published results.

Nikhil Jain, MD, and colleagues retrospectively analyzed information from 849 patients with osteoporosis who underwent spinal fusion of three levels or more for degenerative pathology. According to the study, outcomes measures included osteoporosis-related complications (ORC) at 1 year postoperatively, overall complications, pathological fracture and revision surgery.

Among the cohort, 14.3% of patients (n = 121) received preoperative pharmacological treatments for osteoporosis. The most commonly used treatments included risedronate sodium, ibandronate sodium, alendronate sodium, zoledronic acid and teriparatide. Of these 121 preoperatively treated patients, 43% (n = 52) continued with their prescription for 1 year after surgery.

Jain and colleagues found treated patients had a 1-year ORC incidence of 9.1%, while non-treated patients had a 1-year ORC incidence of 15%. Researchers also noted that no treated patients with ORC underwent revision surgery, while 18.3% (n = 20) of the non-treated patients with ORC underwent revision fusion. Additionally, the average 1-year reimbursement per patient with ORC was $3,053 in the treated group and was $21,147 in the non-treated group.

“There is a low incidence of osteoporosis treatment prior to spinal fusion, and subsequently a low rate of treatment continuation after surgery,” Jain and colleagues wrote in the study. “These findings highlight the need for heightened awareness, patient education and management of osteoporosis before elective multi-level spinal fusion,” they added.