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The role of bone mineral density in adult spinal deformity patients undergoing corrective surgery: a matched analysis

  • Original Article - Spine degenerative
  • Published:
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Abstract

Study design

Retrospective cohort.

Background

Over 44 million adults are estimated to have either osteoporosis or osteopenia. Adult spinal deformity (ASD) is estimated to affect between 32 and 68% of the elderly population.

Objective

Retrospective investigation comparing rates of postoperative complications following thoracolumbar scoliosis surgery in patients with normal bone mineral density (BMD) to those with osteopenia or osteoporosis in addition to analyzing the effects of pretreatment with anti-osteoporotic medications in patients with low BMD.

Methods

Using administrative database of Humana beneficiaries, ICD-9 and ICD-10 diagnosis codes were used to identify ASD patients undergoing multilevel thoracolumbar fusions between 2007 and 2017.

Results

The propensity matched population analyzed in this study contained 1044 patients equally represented by those with a history of osteopenia, osteoporosis, or normal BMD. Osteopenia and osteoporosis were associated with increased odds of revision surgery (OR 2.01 95% CI 1.36–2.96 and OR 1.57, 95% CI 1.05–2.35), respectively. Similarly, there was an almost twofold increased odds of proximal and distal junctional kyphosis in patients with osteopenia and osteoporosis (OR 1.95, 95% CI 1.40–2.74 and OR 1.88, 95% CI 1.34–2.64), respectively. A total of 258 (37.1%) patients with osteoporosis were pretreated with anti-osteoporotic medications and there was no statistically significant decrease in odds of proximal or distal junctional kyphosis or revision surgery in these patients.

Conclusion

Patients with ASD undergoing multilevel thoracolumbar fusion surgery have significantly higher rates of postoperative pseudarthrosis, proximal and distal junctional kyphosis, and revision surgery rates compared to patients with normal BMD.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Illinois, Chicago, IL, USA

    Syed I. Khalid, Ravi S. Nunna & Ankit I. Mehta

  2. Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA

    Jennifer S. Smith, Rachyl M. Shanker, Alecia A. Cherney & Kyle B. Thomson

  3. Department of Neurosurgery, University of Texas Southwestern Medical School, Dallas, TX, USA

    Sai Chilakapati

  4. Department of Neurosurgery, University of Cincinatti, Cincinnati, OH, USA

    Owoicho Adogwa

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  1. Syed I. Khalid
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Correspondence to Syed I. Khalid.

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Khalid, S.I., Nunna, R.S., Smith, J.S. et al. The role of bone mineral density in adult spinal deformity patients undergoing corrective surgery: a matched analysis. Acta Neurochir 164, 2327–2335 (2022). https://doi.org/10.1007/s00701-022-05317-4

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  • DOI: https://doi.org/10.1007/s00701-022-05317-4

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