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Related Experiment Video

Updated: Jan 7, 2026

Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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Bone Optimization for Perioperative Spine Patients: A Multidisciplinary Approach at a Single Academic Center.

Maria Valentina Suarez-Nieto1, Karen Malacon1, Andrea Fox2

  • 1Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA 94305, USA.

Journal of Clinical Medicine
|December 30, 2025
PubMed
Summary

Implementing a Bone Health Clinic (BHC) for spine surgery patients improved osteoporosis treatment rates and showed promising early surgical outcomes. Barriers like insurance and contraindications influenced medication choices, highlighting the need for further research.

Keywords:
bone health clinicbone optimizationfracture liaison serviceperioperative spine patient

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Area of Science:

  • Orthopedics and Bone Health
  • Surgical Outcomes and Patient Management
  • Pharmacotherapy and Treatment Efficacy

Background:

  • Osteoporosis and low bone mineral density are prevalent in spinal fusion patients, increasing risks of hardware failure and revision surgery.
  • Inconsistent perioperative screening and treatment for osteoporosis create a significant care gap.
  • Bone Health Clinics (BHCs) and Fracture Liaison Services (FLSs) offer multidisciplinary solutions to address this gap.

Purpose of the Study:

  • To describe the implementation of a dedicated BHC at an academic center.
  • To evaluate perioperative pharmacotherapy patterns, treatment barriers, and surgical outcomes in spine patients referred to the BHC.
  • To assess bone health response to treatment via follow-up DXA scans.

Main Methods:

  • Retrospective review of 174 consecutive perioperative spine patients referred to the BHC (October 2019 - April 2024).
  • Data collected included demographics, surgical details, bone health status (DXA, fracture history), laboratory results, pharmacologic management, contraindications, insurance barriers, and medication sequencing.
  • Surgical outcomes (hardware failure, revision surgery) and bone health response (follow-up DXA) were analyzed.

Main Results:

  • The cohort (mean age 71.9 years) showed high rates of osteopenia (27.0%) and osteoporosis (56.3%).
  • Pharmacotherapy was initiated in 83.9% of patients, with romosozumab, denosumab, and abaloparatide being most common.
  • Insurance barriers impacted anabolic agents more than denosumab; 60% of patients with follow-up DXA showed improved bone mineral density.

Conclusions:

  • Integrating a multidisciplinary BHC into perioperative spine care is feasible and increases pharmacotherapy initiation.
  • Favorable early surgical outcomes were observed, potentially linked to perioperative bone optimization.
  • Insurance and contraindications remain significant barriers to anabolic therapy, influencing drug selection and necessitating further research into long-term impact.