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Bone Mineral Density After Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis at a Minimum 20-Year Follow-up

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Abstract

Study Design

A retrospective, long-term follow-up study.

Objective

We investigated the incidence and risk factors for osteopenia at a minimum of 20 years after spinal instrumented fusion for adolescent idiopathic scoliosis (AIS).

Summary of Background Data

Surgically treated AIS patients may be likely to have osteopenia in adulthood because the association between AIS and osteopenia has been well documented. However, the long-term results of AIS surgery on BMD have not been evaluated.

Methods

Twenty-one (19 women; mean age, 45.3 years) of 45 consecutive patients with AIS who underwent spinal instrumented fusion surgery between 1973 and 1994 consented to inclusion in the current analysis. Based on their T scores for bone mineral density (BMD) of the left hip, participants were divided into an osteopenia/osteoporosis group (group P, T score < −1.0) and a normal group (group N, T score ≤ −1.0). Z scores of the left hip were used for analyses of the association between bone mineral status and individual factors.

Results

Eleven participants (52.4%) were categorized into group P. Mean body weight (kg) at survey (46.6 vs. 56.8) and mean body mass index (BMI) at both surgery (17.2 vs. 19.5) and survey (18.7 vs. 23.2) were significantly lower in group P than in group N (p < .05). Moreover, body weight at survey (Spearman rank correlation coefficient, rS = 0.49), as well as BMI at both surgery (rS = 0.67) and survey irS = 0.61) demonstrated positive correlations with the Z-score (p < .05).

Conclusion

More than half of the participants had osteopenia or osteoporosis, and both preoperative and postoperative low BMI were risk factors for osteopenia in adulthood.

Level of Evidence

Level IV.

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Authors and Affiliations

  1. Division of Orthopedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi Dori, Niigata, Chuo-ku, 951-8510, Japan

    Masayuki Ohashi MD, PhD, Toru Hirano MD, PhD, Kei Watanabe MD, PhD, Keiichi Katsumi MD, PhD, Hirokazu Shoji MD, PhD, Tatsuki Mizouchi MD & Naoto Endo MD, PhD

  2. Department of Orthopedic Surgery, Uonuma Kikan Hospital, Minamiuonuma City, Niigata, Urasa, 4132 949-7302, Japan

    Keiichi Katsumi MD, PhD

Authors
  1. Masayuki Ohashi MD, PhD
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  2. Toru Hirano MD, PhD
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  3. Kei Watanabe MD, PhD
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  4. Keiichi Katsumi MD, PhD
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  5. Hirokazu Shoji MD, PhD
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  6. Tatsuki Mizouchi MD
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  7. Naoto Endo MD, PhD
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Corresponding author

Correspondence to Masayuki Ohashi MD, PhD.

Additional information

MO (none); TH (none); KW (none); KK (none); HS (none); TM (none); NE (none).

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Ohashi, M., Hirano, T., Watanabe, K. et al. Bone Mineral Density After Spinal Fusion Surgery for Adolescent Idiopathic Scoliosis at a Minimum 20-Year Follow-up. Spine Deform 6, 170–176 (2018). https://doi.org/10.1016/j.jspd.2017.09.002

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  • DOI: https://doi.org/10.1016/j.jspd.2017.09.002

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