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Effects of Osteoporosis Medication Use on Reprocedure Rates Following Vertebral Augmentation: A Nationwide Cohort Study

Park SR, Lee BH, Suk KS, Kim N, Park M, Park SY, Moon SH, Kim HS et al.

Clinics in orthopedic surgery, 2025

9,070 participants

Abstract

BACKGROUD: In this study, we aimed to investigate the effects of osteoporosis medication use and prescription duration on the rates of reprocedures for re-fractures in patients who underwent vertebral augmentation (VA).

METHODS: This retrospective cohort study was conducted using data collected from the National Health Insurance Service database of South Korea. Patients aged 50 years or older who underwent VA in 2012 were included in this study. A reprocedure was defined as an additional VA performed for re-fractures during a follow-up period of up to 5 years. Patients were categorized based on medication type (bisphosphonates, selective estrogen receptor modulators [SERMs], calcium supplements, or vitamin D supplements) and prescription duration (incomplete, complete, or absolute complete). The results were statistically analyzed using Cox regression and Kaplan-Meier survival analyses.

RESULTS: Among 9,070 patients included, 678 patients (7.5%) underwent reprocedures for re-fractures, with 41.0% of reprocedures performed within 6 months after VA. The reprocedure rate was higher in patients prescribed calcium or vitamin D supplements (13.3%) than in those prescribed bisphosphonates (7.7%) or SERMs (8.6%). Multivariate analysis revealed that prolonged prescription duration was associated with higher reprocedure rates, reflecting greater disease severity. The absolute complete prescription group showed a 9.07 times higher hazard ratio for reprocedure than the no-medication…

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: 9,070 participants or records.

How the five levels of evidence work. The level is assigned automatically from the abstract and can be wrong, so check the paper.

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