Untreated Osteoporosis in Lumbar Fusion Surgery Patients: Prevalence, Risk-factors, and Effect on Bone Metabolism
Abstract
STUDY DESIGN: Secondary analysis of a prospective single-center study.
OBJECTIVE: To analyze the prevalence and risk factors for untreated osteoporosis in patients undergoing lumbar spinal fusion surgery (LFS) and its impact on bone mineral density (BMD) and bone turnover markers.
BACKGROUND: Osteoporosis is a risk factor for mechanical complications in LFS, which can be mitigated by antiosteoporotic treatment. However, there is limited research on factors leading to untreated osteoporosis before LFS and its impact on preoperative bone status.
MATERIALS AND METHODS: A secondary analysis of a prospective study enrolling adults undergoing LFS for degenerative conditions (2014-2024) with preoperative quantitative CT osteoporosis screening was performed. Demographic data and medical history were analyzed for prevalence and risk factors of untreated osteoporosis, while BMD, vitamin D, PTH levels, and bone turnover markers were assessed for the effects of lacking treatment.
RESULTS: A total of 445 patients (48% female, median age 64) were included, of which 137 patients (31%) had osteoporosis. Of these, 66 (48%) were untreated and 71 (52%) were treated, with 40 (56%) receiving pharmacological and 31 (44%) nonpharmacologic treatment, including vitamin D supplementation and lifestyle modifications. Of the untreated patients, 55 (80%) were identified by preoperative screening. Seventy-one percent of osteoporotic men versus 35% of osteoporotic women were untreated ( P <0.001).…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 445 participants or records.
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