Bone-Targeted Therapies and Spinal Morphometry in Postmenopausal Osteoporosis: A Real-World Longitudinal
Zhen-Wei Wu1,2, Szu-Wei Chen1,2, Sz-Huei Li3
1Department of Medical Education, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taipei 231405, Taiwan.
Bioengineering (Basel, Switzerland)
|July 28, 2026
Summary
Anabolic therapy in postmenopausal women with osteoporosis did not show clear benefits on spinal morphometrics. Spinopelvic morphology, not treatment, may influence spinal adaptation in osteoporosis.
Area of Science:
- Orthopedics
- Osteoporosis Research
- Spinal Biomechanics
Background:
- Osteoporosis significantly impacts bone mineral density (BMD) and spinal structure.
- Understanding spinal morphometric changes is crucial for managing osteoporosis.
- Anabolic therapies aim to improve bone density, but their effect on spinal morphology needs further evaluation.
Purpose of the Study:
- To evaluate longitudinal spinal morphometric changes in postmenopausal women with osteoporosis.
- To compare changes between anabolic and non-anabolic anti-osteoporotic therapies.
- To explore the influence of spinopelvic parameters on spinal adaptation.
Main Methods:
- Retrospective observational study of 128 postmenopausal women over 24 months.
- Assessed lumbar BMD, vertebral heights, disc height indices, and sagittal spinopelvic parameters.
- Used linear regression, inverse probability of treatment weighting (IPTW), and overlap weighting.
Main Results:
- Both groups achieved significant lumbar BMD improvement.
- Anabolic therapy showed potential associations with L5 height loss and L5/S1 disc height preservation, but these were attenuated by confounding factors.
- Pelvic incidence consistently influenced L5 anterior height change and L5/S1 disc height preservation.
Conclusions:
- Confounding by indication limits causal interpretation of treatment-related morphometric findings.
- Spinopelvic morphology appears to influence lower lumbar structural adaptation in osteoporosis.
- Treatment-related morphometric findings require further investigation and confirmation.
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