Spine surgery patients with undiagnosed osteoporosis — 5 things to know

Written by Shayna Korol | March 15, 2019 | Print  |

A study at New York City-based Hospital for Special Surgery found that a significant number of lumbar spine surgery patients had previously undiagnosed osteoporosis.

The research was presented at the American Academy of Orthopaedic Surgeons Annual Meeting in Las Vegas, March 12 to 16.

Five things to know:

1. The study enrolled 296 patients undergoing lumbar spine fusion for a degenerative condition or spinal instability. All patients underwent preoperative quantitative CT scans of their lumbar spine.

2. Using American College of Radiology criteria, 44 percent of patients received a osteopenia diagnosis; 15 percent had osteoporosis; and 41 percent were had normal bone density.

3. Patients older than 50 years old were significantly more likely to receive a low bone density diagnosis: 49 percent of these patients were diagnosed with osteopenia and 18 percent had osteoporosis.

4. "The literature reporting QCT-based lumbar spine bone density is scarce, and we believe our study is the first of its kind," said HSS orthopedic spine surgeon and senior investigator Alexander P. Hughes, MD. "We believe that QCT is more effective in screening patients because the DXA scan can overestimate bone density in the spine due to certain bone changes, a patient's weight or physique and other factors."

5. "Spine surgeons should be aware of the high prevalence of abnormal bone mineral density in lumbar spine patients and the possibility that those without a previous diagnosis may have osteopenia or osteoporosis," Dr. Hughes said. "Diagnosing this prior to spine fusion could lead to a change in surgical planning and treatment, and we believe this would improve outcomes."

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