Bone union after spinal fusion surgery using local bone in long-term bisphosphonate users: a prospective comparative study
- Authors
- Kang, Taewook; Park, Si Young; Hong, Seok Ha; Lee, Jin Hyeok; Lee, Soon Hyuck; Park, Jong Hoon
- Issue Date
- 29-6월-2019
- Publisher
- SPRINGER LONDON LTD
- Keywords
- Spinal fusion; Bisphosphonates; Bone union; Long-term user
- Citation
- ARCHIVES OF OSTEOPOROSIS, v.14, no.1
- Indexed
- SCIE
SCOPUS
- Journal Title
- ARCHIVES OF OSTEOPOROSIS
- Volume
- 14
- Number
- 1
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/64720
- DOI
- 10.1007/s11657-019-0628-8
- ISSN
- 1862-3522
- Abstract
- The SummaryBisphosphonates are the most commonly used drugs for osteoporosis and long-term use of bisphosphonates may affect fusion rate after spinal fusion surgery. There was significant delayed union after 6months in long-term bisphosphonates users; however, there were no significant difference in fusion rate of long-term bisphosphonate users. Therefore, spinal fusion surgery should not be hesitated in long-term bisphosphonates users.PurposeBisphosphonates (BPs) are the most popular class of drugs for treatment of postmenopausal osteoporosis. Long-term use of BPs may also inhibit the spinal fusion process after posterior lumbar interbody fusion (PLIF). We compared bone fusion rates of long-term BPs users and non-users after undergoing spinal fusion surgery.MethodsA total of 97 postmenopausal women who were candidates for single-level PLIF were recruited from 2015 to 2016. Participants were divided into two groups, with 63 patients in a long-term BPs user group and 34 patients in a non-user group. Serum C-terminal cross-linking telopeptide (CTX) levels were checked for bone resorption markers. Bone fusion rates were calculated at 6months and 1 and 2years after the surgery. Clinical outcomes were measured using the Oswestry Disability Index (ODI) and visual analog scale (VAS).ResultsSerum CTX level was dramatically decreased in the long-term BPs user group (p<0.05). Fusion rates at 6months after surgery were 42% in the non-user group and 26% in the long-term BPs user group (p=0.035). However, fusion rates were 82% in the long-term BPs user group and 87% in the non-user group at 2years after surgery (p>0.05). There was no significant difference between the two groups in ODI or VAS.ConclusionsEven though there was significant delayed union after 6months in long-term BPs users, at the 2-year postoperative follow-up, there was no significant difference in bone fusion rate between the two groups. Long-term BPs users showed fusion rates greater than 80% and clinical outcome improvements that were comparable to those in non-users. No significant effect on fusion rate after PLIF was found in long-term BPs users.
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