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Minimally Invasive Spinal Deformity Surgery pp 123–133Cite as

Management of Osteoporotic Bone

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Abstract

As the population ages and life span increases, the prevalence of osteoporosis, defined as a dual-energy X-ray absorptiometry scan (DEXA) value < −2.5, is increasing [12, 59]. Concomitant with this increase is an increase in spinal fractures and deformity associated with osteoporosis [19, 60]. As techniques for spinal instrumentation improve, spinal surgery is being considered in older patients, many of whom have osteoporosis [9, 12, 17, 19, 30, 33, 35, 36, 38, 45, 52, 57, 59, 64, 66, 70, 72, 74, 76]. It is estimated that in patients over the age of 50 who undergo spine surgery, 51.3 % of females and 14.5 % of males have osteoporosis [12]. Of women who undergo surgery for scoliosis correction, it is estimated that 10 % have osteoporosis [83]. Osteoporosis is a significant independent predictor of complications, particularly hardware related, in spine surgery [17, 64]. As a result, particular attention must be paid when instrumenting the osteoporotic spine [30]. With the advancement and expansion of minimally invasive techniques [18, 36, 37, 45, 51, 58, 66, 69] including for deformity correction [1, 2, 4, 15, 54, 77], it is important for the spine surgeon to carefully follow patients with osteoporosis undergoing spinal fusions to ensure they do not develop pseudoarthrosis and/or implant loosening.

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Authors and Affiliations

  1. Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, USA

    John E. Ziewacz, Darryl Lau & Praveen V. Mummaneni

  2. Department of Orthopedic Surgery, University of California, San Francisco, San Francisco, CA, USA

    Sigurd H. Berven

  3. University of Miami, Miami, FL, USA

    Armed J. Awad

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  1. John E. Ziewacz
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  2. Darryl Lau
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  3. Sigurd H. Berven
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  4. Armed J. Awad
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  5. Praveen V. Mummaneni
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Correspondence to Praveen V. Mummaneni .

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Editors and Affiliations

  1. Dept. of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA

    Michael Y. Wang

  2. Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts, USA

    Yi Lu

  3. Department of Orthopaedics, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

    D. Greg Anderson

  4. Department of Neurological Surgery, University of California, San Francisco, San Francisco, California, USA

    Praveen V. Mummaneni

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Ziewacz, J.E., Lau, D., Berven, S.H., Awad, A.J., Mummaneni, P.V. (2014). Management of Osteoporotic Bone. In: Wang, M., Lu, Y., Anderson, D., Mummaneni, P. (eds) Minimally Invasive Spinal Deformity Surgery. Springer, Vienna. https://doi.org/10.1007/978-3-7091-1407-0_15

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