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Bone Health, Advances in Assessment and Treatment

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Treatment of Spine Disease in the Elderly

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Abstract

Spinal surgical procedures such as fusion are common in the elderly population and may be associated with high rate of complications. A successful surgery can be life-changing by correcting debilitating deformities. In elderly patients, however, it can become particularly challenging given underlying impaired bone strength due to age- and menopause-related loss of bone mass and deterioration of bone microstructure. Poor bone quality is a risk factor for postoperative complications such as delayed healing, hardware loosening/failure, and adjacent compression deformities.

Assessment of bone strength by standard of care techniques may also be affected by the spine disease itself. Bone density measurement of the spine by dual-energy X-ray absorptiometry (DXA) is often falsely elevated and therefore can be misleading due to underlying artifact by degenerative spine disease, osteophytes, and scoliosis. Newer methods of assessing bone quality preoperatively have been promising.

Efforts to improve bone quality within a reasonable time frame and reduce risk of complications include perioperative use of antiresorptive or anabolic agents.

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Authors and Affiliations

  1. Weill Cornell Medical School, New York, NY, USA

    Panagiota Andreopoulou

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  1. Panagiota Andreopoulou
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Correspondence to Panagiota Andreopoulou .

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Editors and Affiliations

  1. Weill Cornell Medical College, New York, NY, USA

    Kai-Ming G. Fu

  2. Departments of Neurosurgery & Rehab Medicine, University of Miami School of Medicine, Miami, FL, USA

    Michael Y. Wang

  3. Department of Neurological Surgery, Weill Cornell Medical Center, New York, NY, USA

    Michael S. Virk

  4. Dept. of Orthopedic Surgery, Leatherman Spine Center, University of Louisville, Louisville, KY, USA

    John R. Dimar II

  5. UCSF Neurosurgery, San Francisco, CA, USA

    Praveen V. Mummaneni

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Andreopoulou, P. (2023). Bone Health, Advances in Assessment and Treatment. In: Fu, KM.G., Wang, M.Y., Virk, M.S., Dimar II, J.R., Mummaneni, P.V. (eds) Treatment of Spine Disease in the Elderly. Springer, Cham. https://doi.org/10.1007/978-3-031-12612-3_1

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  • DOI: https://doi.org/10.1007/978-3-031-12612-3_1

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  • Online ISBN: 978-3-031-12612-3

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