J Korean Neurosurg Soc.  2011 Jun;49(6):317-322. 10.3340/jkns.2011.49.6.317.

Strategies of Spinal Fusion on Osteoporotic Spine

• Park SB
• Chung CK

• KMID: 2066827
• DOI: http://doi.org/10.3340/jkns.2011.49.6.317

Abstract

The prevalence of osteoporosis has been increasing globally. Recently surgical indications for elderly patients with osteoporosis have been increasing. However, only few strategies are available for osteoporotic patients who need spinal fusion. Osteoporosis is a result of negative bone remodeling from enhanced function of the osteoclasts. Because bone formation is the result of coupling between osteoblasts and osteoclasts, anti-resorptive agents that induce osteoclast apoptosis may not be effective in spinal fusion surgery, necessitating new bone formation. Therefore, anabolic agents may be more suitable for osteoporotic patients who undergo spinal fusion surgery. The instrumentations and techniques with increased pullout strength may increase fusion rate through rigid fixation. Studies on new osteoinductive materials, methods to increase osteogenic cells, strengthened and biocompatible osteoconductive scaffolds are necessary to enable osteoporotic patients to undergo spinal fusion. When osteoporotic patients undergo spinal fusion, surgeons should consider appropriate osteoporosis medication, instrumentation and technique.

Keyword

Osteoporosis; Spine; Fusion; Osteoblast; Osteoclast

MeSH Terms

Aged
Anabolic Agents
Apoptosis
Bone Remodeling
Durapatite
Humans
Osteoblasts
Osteoclasts
Osteogenesis
Osteoporosis
Prevalence
Spinal Fusion
Spine
Anabolic Agents
Durapatite