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Osteoporosis as a Risk Factor for Intraoperative Complications and Long-term Instrumentation Failure in Patients With
Luke Mugge1, Danielle DeBacker Dang1, Andrew Caras2
1Department of Neurosurgery, Inova Neuroscience and Spine Institute, Falls Church, VA.
Spine
|September 29, 2022
Summary
Osteoporosis significantly increases risks for spine surgery patients, leading to higher rates of instrumentation failure and revision surgery. This condition also elevates the likelihood of blood loss and dangerous blood clots after spinal fusion.
Area of Science:
- Orthopedics
- Spine Surgery
- Bone Metabolism
Background:
- Osteoporosis is a common condition affecting bone health and remodeling.
- It accelerates spinal degeneration, often requiring surgical intervention for deformities and stenosis.
- Limited research exists on osteoporosis's impact on spine fusion outcomes and complications.
Purpose of the Study:
- To investigate the effect of osteoporosis on spine instrumentation outcomes.
- To identify perioperative complications associated with osteoporosis in spine surgery.
Main Methods:
- Retrospective review of a prospectively maintained database.
- Analysis of patients undergoing spine surgery for thoracolumbar scoliosis correction (2006-2017).
- Inclusion criteria: age 18+, scoliosis correction surgery.
Main Results:
- 144 of 532 patients (27%) had osteoporosis.
- Osteoporosis correlated with increased blood loss (P=0.003).
- Higher rates of instrumentation failure (19% vs. 10%) and revision surgery (33% vs. 16%) in osteoporotic patients.
- Multivariate analysis confirmed osteoporosis as a risk factor for fusion segments, blood loss, DVT/PE, instrumentation failure, and revision surgery.
Conclusions:
- Osteoporosis is a significant risk factor for instrumentation failure and revision surgery after scoliosis correction.
- Patients with osteoporosis face higher risks of intraoperative blood loss and postoperative thromboembolic events.
