Effect of bisphosphonates or teriparatide on mechanical complications after posterior instrumented fusion for osteoporotic vertebral fracture: a multi-center retrospective study

Autor: Yasuchika Aoki, Masayuki Shimizu, Masayuki Ohashi, Hirooki Endo, Katsumi Harimaya, Syuta Yamada, Toshinori Tsukanishi, Koji Tamai, Tomoya Yamashita, Hirosuke Nishimura, Yuta Shiono, Ken Ishii, Eijiro Okada, Michio Hongo, Katsuhito Kiyasu, Hidekazu Suzuki, Masashi Oshima, Norihiro Isogai, Masayuki Miyagi, Shinji Adachi, Kei Watanabe, Shoji Seki, Atsuyuki Kawabata, Tadashi Nukaga, Kei Ando, Seiji Ohtori, Kazuyoshi Kobayashi, Hidetomi Terai, Haruki Funao, Kenya Nojiri, Akira Iwata, Toshitaka Yoshii, Shuta Ushio, Nobuhiko Yokoyama, Atsushi Nakano, Seiji Ueda, Shota Ikegami, Toshimasa Futatsugi, Hidekazu Oishi, Takeo Furuya, Takashi Yurube, Katsuhito Yoshioka, Atsushi Tagami, Daisuke Sakai, Kota Watanabe, Takashi Hirai, Yuji Matsuoka, Keiichi Katsumi, Kazuyoshi Nakanishi, Kenichiro Kakutani, Tetsuya Abe, Hiroyasu Fujiwara, Tomohiro Hikata, Hideki Murakami, Gen Inoue, Yukitaka Nagamoto, Naobumi Hosogane, Masahiko Takahata, Takashi Kaito, Toshiro Doi, Satoshi Suzuki, Yohei Shibuya, Hirokazu Inoue, Sumihisa Orita, Wataru Saito, Shiro Imagama, Atsushi Kimura, Kenichi Kawaguchi
Rok vydání: 2020
Předmět:
Zdroj: BMC Musculoskeletal Disorders
BMC Musculoskeletal Disorders, Vol 21, Iss 1, Pp 1-10 (2020)
ISSN: 1471-2474
DOI: 10.1186/s12891-020-03452-6
Popis: Background The optimal treatment of osteoporosis after reconstruction surgery for osteoporotic vertebral fractures (OVF) remains unclear. In this multicentre retrospective study, we investigated the effects of typically used agents for osteoporosis, namely, bisphosphonates (BP) and teriparatide (TP), on surgical results in patients with osteoporotic vertebral fractures. Methods Retrospectively registered data were collected from 27 universities and affiliated hospitals in Japan. We compared the effects of BP vs TP on postoperative mechanical complication rates, implant-related reoperation rates, and clinical outcomes in patients who underwent posterior instrumented fusion for OVF. Data were analysed according to whether the osteoporosis was primary or glucocorticoid-induced. Results A total of 159 patients who underwent posterior instrumented fusion for OVF were included. The overall mechanical complication rate was significantly lower in the TP group than in the BP group (BP vs TP: 73.1% vs 58.2%, p = 0.045). The screw backout rate was significantly lower and the rates of new vertebral fractures and pseudoarthrosis tended to be lower in the TP group than in the BP group. However, there were no significant differences in lumbar functional scores and visual analogue scale pain scores or in implant-related reoperation rates between the two groups. The incidence of pseudoarthrosis was significantly higher in patients with glucocorticoid-induced osteoporosis (GIOP) than in those with primary osteoporosis; however, the pseudoarthrosis rate was reduced by using TP. The use of TP also tended to reduce the overall mechanical complication rate in both primary osteoporosis and GIOP. Conclusions The overall mechanical complication rate was lower in patients who received TP than in those who received a BP postoperatively, regardless of type of osteoporosis. The incidence of pseudoarthrosis was significantly higher in patients with GIOP, but the use of TP reduced the rate of pseudoarthrosis in GIOP patients. The use of TP was effective to reduce postoperative complications for OVF patients treated with posterior fusion.
Databáze: OpenAIRE
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