Teriparatide versus low-dose bisphosphonates before and after surgery for adult spinal deformity in female Japanese patients with osteoporosis

• Published in: European spine journal Vol. 26; no. 8; pp. 2121 - 2127
• Main Authors: Seki, Shoji, Hirano, Norikazu, Kawaguchi, Yoshiharu, Nakano, Masato, Yasuda, Taketoshi, Suzuki, Kayo, Watanabe, Kenta, Makino, Hiroto, Kanamori, Masahiko, Kimura, Tomoatsu
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.08.2017; Springer Nature B.V
• Subjects: Aged; Aged, 80 and over; Bisphosphonates; Bone Density Conservation Agents - therapeutic use; Computed tomography; Diphosphonates - therapeutic use; Drug Administration Schedule; Female; Females; Fractures; Humans; Medicine; Medicine & Public Health; Middle Aged; Neurosurgery; Original Article; Osteoporosis; Osteoporosis, Postmenopausal - complications; Osteoporosis, Postmenopausal - drug therapy; Pain; Parathyroid hormone; Perioperative Care - methods; Prospective Studies; Spinal Curvatures - etiology; Spinal Curvatures - surgery; Surgery; Surgical Orthopedics; Teriparatide - therapeutic use; Treatment Outcome; Vertebrae; Teriparatide/TU bisphosphonates; Orthopedic procedures/AE; Osteoporosis/SU; Disability evaluation
• ISSN: 0940-6719; 1432-0932
• DOI: 10.1007/s00586-017-4959-0

Purpose Complications of adult spinal deformity surgery are problematic in osteoporotic individuals. We compared outcomes between Japanese patients treated perioperatively with teriparatide vs. low-dose bisphosphonates. Methods Fifty-eight osteoporotic adult Japanese female patients were enrolled and assigned to perioperative teriparatide (33 patients) and bisphosphonate (25 patients) groups in non-blinded fashion. Pre- and post-operative X-ray and computed tomography imaging were used to assess outcome, and rates were compared between the groups and according to age. Pain scores and Oswestry Disability Indices (ODI) were calculated before and 2 years after surgery. Results Adjacent vertebral fractures and implant failure, fusion failure, and poor pain and ODI outcomes were significantly more common in the bisphosphonates group than the teriparatide group. Conclusions Perioperative administration of teriparatide is more effective than that of low-dose bisphosphonates in preventing complications and maintaining fusion rates in osteoporotic Japanese females with spinal deformities undergoing surgery.