Osteoporosis in Adult Patients Undergoing Spinal Reconstructive Surgery: Associated Complications and Management

Area of Science:

• Orthopedic Surgery
• Bone Metabolism
• Radiology

Background:

• Osteoporosis is prevalent in adults undergoing spinal reconstructive surgery, with incidences ranging from 10% to 50%.
• Osteopenia is also common, affecting 41.4% to 58.6% of these patients.
• Suboptimal bone health increases risks for surgical complications.

Purpose of the Study:

• To review complications and management strategies for adult osteoporosis patients undergoing spinal reconstructive surgery.
• To emphasize screening, diagnosis, and perioperative medical and surgical management.
• To highlight current evidence on optimizing outcomes in this patient population.

Main Methods:

• Literature review of studies on osteoporosis in adult spine surgery patients.
• Analysis of associated complications, treatment, and prevention methodologies.
• Evaluation of diagnostic tools and therapeutic interventions.

Main Results:

• High incidence of osteoporosis (10-50%) and osteopenia (41.4-58.6%) in patients undergoing spinal reconstruction.
• Dual-energy X-ray absorptiometry (DEXA) is common, but quantitative CT (QCT) is optimal for spinal bone mineral density (BMD).
• Opportunistic CT-based Hounsfield Units (CTHU) correlate with complications; Teriparatide and surgical modifications (cement augmentation, iliac fixation) show promise.

Conclusions:

• Osteoporosis is a significant concern in patients requiring spinal reconstruction.
• Optimized preoperative and postoperative medical management can lower adverse events.
• Tailored surgical techniques are crucial for addressing compromised bone health and improving outcomes.