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An effect comparison of teriparatide and bisphosphonate on posterior lumbar interbody fusion in patients with osteoporosis: a prospective cohort study and preliminary data

Authors
 Pyung Goo Cho  ;  Gyu Yeul Ji  ;  Dong Ah Shin  ;  Yoon Ha  ;  Do Heum Yoon  ;  Keung Nyun Kim 
Citation
 European Spine Journal, Vol.26(3) : 691-697, 2017 
Journal Title
 European Spine Journal 
ISSN
 0940-6719 
Issue Date
2017
MeSH
Administration, Oral ; Aged ; Alendronate/therapeutic use* ; Bone Density ; Bone Density Conservation Agents/therapeutic use* ; Cohort Studies ; Disability Evaluation ; Female ; Humans ; Injections, Subcutaneous ; Lumbar Vertebrae/surgery ; Osseointegration ; Osteoporosis, Postmenopausal/drug therapy* ; Pedicle Screws ; Spinal Fusion* ; Spinal Stenosis/surgery ; Spondylolisthesis/surgery ; Teriparatide/therapeutic use* ; Visual Analog Scale
Keywords
Bisphosphonate ; Osteoporosis ; Spinal fusion ; Teriparatide
Abstract
PURPOSE: Our purpose was to evaluate the efficacy of teriparatide for posterior lumbar interbody fusion (PLIF) in osteoporotic women. METHODS: Forty-seven osteoporotic patients underwent PLIF with pedicle screw fixation for degenerative lumbar stenosis and instability. Patients were divided into two groups. The teriparatide group (n = 23) was injected subcutaneously with teriparatide (20 μg daily) for 3-month cycles alternating with 3-month periods of oral sodium alendronate for 12 months. The bisphosphonate group (n = 24) was administered oral sodium alendronate (91.37 mg/week) for ≥1 year. Serial plain radiography, computed tomography, and bone mineral densitometry (BMD) evaluations were performed. Fusion rate, bony fusion duration, and T score changes were evaluated. Clinical data [pain scores, Prolo's functional scale, and Oswestry disability index (ODI)] were also serially evaluated. RESULTS: The teriparatide group showed earlier fusion than the bisphosphonate group. The average period of bone fusion was 6.0 ± 4.8 months in the teriparatide group but 10.4 ± 7.2 months in the bisphosphonate group. The bone fusion rate in the teriparatide group was higher than that in the bisphosphonate group at 6 months; however, there was no difference 12 and 24 months after surgery. Pain scores and ODI were not significantly different between groups. BMD scores in the teriparatide group were significantly improved compared with the bisphosphonate group 2 years after surgery. CONCLUSIONS: There was no significant improvement in overall fusion rate and clinical outcome in our patients after injection of teriparatide, but the teriparatide group showed faster bony union and highly improved BMD scores.
Full Text
https://link.springer.com/article/10.1007%2Fs00586-015-4342-y
DOI
10.1007/s00586-015-4342-y
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
김긍년(Kim, Keung Nyun)
신동아(Shin, Dong Ah) ORCID logo https://orcid.org/0000-0002-5225-4083
윤도흠(Yoon, Do Heum) ORCID logo https://orcid.org/0000-0003-1452-5724
하윤(Ha, Yoon)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154285
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