Skip to main content
Log in

Prevalence of osteoporosis in patients requiring spine surgery: incidence and significance of osteoporosis in spine disease

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

Summary

The purpose of this study is to evaluate the incidence of osteoporosis in patients requiring spine surgery. Among patients older than 50 years, the rate of osteoporosis in males was 14.5% and the rate osteoporosis in females was 51.3%. We strongly recommend an evaluation and treatment for osteoporosis in the patients requiring spine surgery, especially in females over 50 years old.

Introduction

Because lifespan is increasing, there is an increase in the incidence of osteoporosis in elderly spine surgery patients. The osteoporosis may adversely influence the fusion rate and the surgical outcome. The purpose of this study is to evaluate the incidence of osteoporosis in patients requiring spine surgery.

Methods

A total of 1,321 patients underwent spine surgeries at our institute from January 1, 2005 to December 31, 2005. Among them, there were 562 patients (42.5%) younger than 50 years old, and 759 patients (57.6%) older than 50 years old. Prior to operation, we evaluated the patients for osteoporosis on both the femur head and lumbar spine by measuring the bone mineral density (BMD) by the dual-energy X-ray absorptiometry (DXA). Based on the World Health Organization (WHO) criteria for osteoporosis, we chose the T-score to determine normal (>−1), osteopenia (−1≥, >−2.5), and osteoporosis (≤−2.5). Among the 562 patients younger than 50 years, DXA was performed in 22 (3.9%) patients and there were 13 (2.3%) cases of osteopenia and 2 (0.3%) cases of osteoporosis.

Results

Among 759 patients older than 50 years, DXA was performed on 516 (68.0%) patients, 193 males and 323 females. Among the male patients, there were 89 (46.1%) patients with osteopenia and 28 (14.5%) with osteoporosis. Among the female patients, there were 134 (41.4%) with osteopenia and 166 (51.3%) with osteoporosis. The incidence of osteoporosis was higher in female patients and significantly increased with increasing age. Among 759 patients older than 50 years, 676 patients underwent a major spine operation with or without fusion. Among these patients, DXA was performed in 446 (66.0%) patients and there were 207 (46.4%) patients with osteopenia and 139 (31.1%) with osteoporosis.

Conclusions

The patients over 50 year-old who need spine operation have osteoporosis often. In conclusion, the number of spine operations in elderly patients is increasing and the incidence of osteoporosis in spine surgery patients is also increasing. We strongly recommend an evaluation for osteoporosis and post-operative treatment for osteoporosis in patients over 50 years old, especially for female patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Anonymous (1993) Consensus development conference: diagnosis, prophylaxis, and treatment of osteoporosis. Am J Med 94:646–650

    Google Scholar 

  2. Forst H (1985) The pathomechanics of osteoporosis. Clin Orthop 200:28

    Google Scholar 

  3. Randell A, Sambrook PN, Nguyen TV, Lapsley H, Jones G, Kelly PJ, Eisman JA (1995) Direct clinical and welfare costs of osteoporotic fractures in elderly men and women. Osteoporos Int 5:427–432

    Article  PubMed  CAS  Google Scholar 

  4. Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4:368–381

    Article  PubMed  CAS  Google Scholar 

  5. Rowe SM, Jung ST, Lee JY (1997) Epidemiology of osteoporosis in Korea. Osteoporos Int 7(Suppl 3):S88–S90

    PubMed  Google Scholar 

  6. Orimo H, Sugioka Y, Fukunaga M, Muto Y, Hotokebuchi T, Gorai I, Nakamura T, Kushida K, Tanaka H, Ikai T, Oh-hashi Y; Diagnost CJSBMRD (1998) Diagnostic criteria of primary osteoporosis. J Bone Miner Metab 16:139–150

    Article  Google Scholar 

  7. Kanis JA, Melton LJ 3rd, Christiansen C, Johnston CC, Khaltaev N (1994) The diagnosis of osteoporosis. J Bone Miner Res 9:1137–1141

    PubMed  CAS  Google Scholar 

  8. Looker AC, Johnston CC Jr, Wahner HW, Dunn WL, Calvo MS, Harris TB, Heyse SP, Lindsay RL (1995) Prevalence of low femoral bone density in older U.S. women from NHANES III. J Bone Miner Res 10:796–802

    Article  PubMed  CAS  Google Scholar 

  9. Kim CH, Kim YI, Choi CS, Park JY, Lee MS, Lee SI, Kim GS (2000) Prevalence and risk factors of low quantitative ultrasound values of calcaneus in Korean elderly women. Ultrasound Medicine Biology 26:35–40

    Article  CAS  Google Scholar 

  10. Siris ES, Brenneman SK, Barrett-Connor E, Miller PD, Sajjan S, Berger ML, Chen YT (2006) The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in postmenopausal women aged 50–99: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int 17:565–574

    Article  PubMed  CAS  Google Scholar 

  11. Muraki S, Yamamoto S, Ishibashi H, Horiuchi T, Hosoi T, Orimo H, Nakamura K (2004) Impact of degenerative spinal diseases on bone mineral density of the lumbar spine in elderly women. Osteoporos Int 15:724–728

    Article  PubMed  Google Scholar 

  12. Paiva LC, Filardi S, Pinto-Neto AM, Samara A, Marques Neto JF (2002) Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis. Sao Paulo Med J 120:9–12

    Article  PubMed  Google Scholar 

  13. Vogt MT, Rubin DA, San Valentin R, Palermo L, Dlnaldson WF, Nevitt M, Cauley JA (1998) Lumbar listhesis and lower back symptoms in elderly white women. The study of osteoporotic fractures. Spine 23:2640–2647

    Article  PubMed  CAS  Google Scholar 

  14. Vogt MT, Rubin DA, San Valentin R, Palermo L, Kang JD, Donaldson WF 3rd, Nevitt M, Cauley JA (1999) Degenerative lumbar listhesis and bone mineral density in elderly women. The study of osteoporotic fractures. Spine 24:2536–2541

    Article  PubMed  CAS  Google Scholar 

  15. Aldini NN, Fini M, Giavaresi G, Giardino R, Greggi T, Parisini P (2002) Pedicular fixation in the osteoporotic spine: a pilot in vivo study on long-term ovariectomized sheep. J Orthop Res 20:1217–1224

    Article  PubMed  Google Scholar 

  16. Coe JD, Warden KE, Herzig MA, McAfee PC (1990) Influence of bone mineral density on the fixation of thoracolumbar implants. A comparative study of transpedicular screws, laminar hooks, and spinous process wires. Spine 15:902–907

    Article  PubMed  CAS  Google Scholar 

  17. Hu SS (1997) Internal fixation in the osteoporotic spine. Spine 22:43S–48S

    Article  PubMed  CAS  Google Scholar 

  18. Peabody JW, Lee SW, Bickel SR (1995) Health for all in the Republic of Korea : one country’s experience with implementing universal health care. Health Policy 31:29–42

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to J. Y. Park.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chin, D.K., Park, J.Y., Yoon, Y.S. et al. Prevalence of osteoporosis in patients requiring spine surgery: incidence and significance of osteoporosis in spine disease. Osteoporos Int 18, 1219–1224 (2007). https://doi.org/10.1007/s00198-007-0370-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00198-007-0370-8

Keywords

Navigation