J Korean Soc Spine Surg.  2015 Sep;22(3):82-91. 10.4184/jkss.2015.22.3.82.

The Effect of Teriparatide in Women with Osteoporosis after Lumbar Posterolateral Fusion or Posterior Lumbar Interbody Fusion

• Seo JH
• Lee KY
• Kim MW

• KMID: 2068925
• DOI: http://doi.org/10.4184/jkss.2015.22.3.82

Abstract

STUDY DESIGN: Retrospective study.
OBJECTIVES
To investigate radiologic and clinical outcomes of teriparatide in women with osteoporosis after instrumented lumbar posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF). SUMMARY OF LITERATURE REVIEW: Teriparatide accelerated lumbar posterolateral fusion in women with postmenopausal osteoporosis.
MATERIALS AND METHODS
Eighty-six women older than 65 years old with osteoporosis underwent PLF or PLIF with bone graft between Februar, 2011 ato May, 2012 pPatients were divided into four group: teriparatide group with local bone (A-1: 13 patients;, teriparatide group with composite bone (A-2: 27 patients; non-teriparatide group with local bone (B-1: 14 patients; and non-teriparatide group with composite bone (B-2: 32 patients). At 3, 6, and 12 months postoperatively, the Oswestry Disability Index (ODI), visual analog scale (VAS), fusion rate, and period of bone union were evaluated.
RESULTS
VAS and ODI improved after surgery in all groups, but no significant differences were notell among the groupses Further, there was no significant difference among the groups for agef fusion level, and fusiops(p>0.05). Fusion rate was 94.44% in the A-1 group, 92.59% in the A-2 group, 79.17% in the B-1 group, and 76.92% in the B-2 group. Average period of bone union was 3.25 months, 3.65 months, 5.67 months, anand 5.65 months respectively. Fusion rate and average bone union time made no significant differeneen among the groups divided by graft materials (p>0.05). However, those in the teriparatide group were significantly superior to those in the non-teriparatide group (p<0.05).
CONCLUSIONS
In women with osteoporosis after PLF or PLIF with bonegraft, teriparatide showed superiority in the rate of fusion and the period of bone union.

Keyword

Teriparatide; Posterolateral fusion; Posterior lumbar interbody fusion; Osteoporosis; Parathyroid hormone

MeSH Terms

Female
Humans
Osteoporosis*
Osteoporosis, Postmenopausal
Parathyroid Hormone
Retrospective Studies
Teriparatide*
Transplants
Visual Analog Scale
Parathyroid Hormone
Teriparatide

Figure

• 

  Fig. 1. At the six month foll ow- up of the 73-year-old woman with posterior lumba r fusion for spinal stenosis L4-L5, L5-S1, dynamic flexion (A) and extension (B) radiographs show less than 2˚ angular motion on L4-L5 after instrumentation withoutscrew loosening.

• 

  Fig. 2. CT scans 6 months after surgery from a 74-year-old woman who underwent posterolateral lumbar fusion of L3-L4, L4-L5with composite bone graft of local bone and allograft. (A) An axial CT image shows big solid trabeculated bilateral fusion massformation bilaterally on L4-L5. (B) A sagittal CT image of the same patient shows continuously sufficient trabecular bone formationin the right transverse processes of L3 to L5.

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