1. Bone union after spinal fusion surgery using local bone in long-term bisphosphonate users: a prospective comparative study
- Author
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Soon Hyuck Lee, Taewook Kang, Seok Ha Hong, Jin Hyeok Lee, Si Young Park, and Jong Hoon Park
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Visual analogue scale ,medicine.medical_treatment ,Osteoporosis ,Urology ,030209 endocrinology & metabolism ,Bone resorption ,03 medical and health sciences ,0302 clinical medicine ,Postoperative Complications ,N-terminal telopeptide ,medicine ,Humans ,Orthopedics and Sports Medicine ,Prospective Studies ,Osteoporosis, Postmenopausal ,Aged ,Aged, 80 and over ,Lumbar Vertebrae ,Diphosphonates ,business.industry ,Bisphosphonate ,Middle Aged ,medicine.disease ,Oswestry Disability Index ,Spinal Fusion ,Treatment Outcome ,Spinal fusion ,Orthopedic surgery ,Female ,030101 anatomy & morphology ,Bone Remodeling ,business ,Tomography, X-Ray Computed - Abstract
Bisphosphonates are the most commonly used drugs for osteoporosis and long-term use of bisphosphonates may affect fusion rate after spinal fusion surgery. There was significant delayed union after 6 months in long-term bisphosphonates users; however, there were no significant difference in fusion rate of long-term bisphosphonate users. Therefore, spinal fusion surgery should not be hesitated in long-term bisphosphonates users.Bisphosphonates (BPs) are the most popular class of drugs for treatment of postmenopausal osteoporosis. Long-term use of BPs may also inhibit the spinal fusion process after posterior lumbar interbody fusion (PLIF). We compared bone fusion rates of long-term BPs users and non-users after undergoing spinal fusion surgery.A total of 97 postmenopausal women who were candidates for single-level PLIF were recruited from 2015 to 2016. Participants were divided into two groups, with 63 patients in a long-term BPs user group and 34 patients in a non-user group. Serum C-terminal cross-linking telopeptide (CTX) levels were checked for bone resorption markers. Bone fusion rates were calculated at 6 months and 1 and 2 years after the surgery. Clinical outcomes were measured using the Oswestry Disability Index (ODI) and visual analog scale (VAS).Serum CTX level was dramatically decreased in the long-term BPs user group (p 0.05). Fusion rates at 6 months after surgery were 42% in the non-user group and 26% in the long-term BPs user group (p = 0.035). However, fusion rates were 82% in the long-term BPs user group and 87% in the non-user group at 2 years after surgery (p 0.05). There was no significant difference between the two groups in ODI or VAS.Even though there was significant delayed union after 6 months in long-term BPs users, at the 2-year postoperative follow-up, there was no significant difference in bone fusion rate between the two groups. Long-term BPs users showed fusion rates greater than 80% and clinical outcome improvements that were comparable to those in non-users. No significant effect on fusion rate after PLIF was found in long-term BPs users.
- Published
- 2019