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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

 Pyung Goo Cho  ;  Gyu Yeul Ji  ;  Dong Ah Shin  ;  Yoon Ha  ;  Do Heum Yoon  ;  Keung Nyun Kim 
 EUROPEAN SPINE JOURNAL, Vol.26(3) : 691-697, 2017 
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Issue Date
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
Bisphosphonate ; Osteoporosis ; Spinal fusion ; Teriparatide
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.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Yoon, Do Heum(윤도흠) ORCID logo https://orcid.org/0000-0003-1452-5724
Ha, Yoon(하윤)
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