Jordan Bauer, Bryan Heard, Hardeep Singh, Scott Mallozzi, Isaac Moss
{"title":"The Role of Osteoporosis in Spine Surgery and Current Management Strategies: A Review.","authors":"Jordan Bauer, Bryan Heard, Hardeep Singh, Scott Mallozzi, Isaac Moss","doi":"10.1007/s11914-025-00930-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose of review: </strong>Osteoporosis is a systemic skeletal disease that presents unique challenges in spine surgery due to decreased bone mass, poor bone quality, and increased risk of fractures. This review aims to synthesize current understanding of osteoporosis in the context of spinal procedures, emphasizing the pathophysiology, diagnostic challenges, perioperative considerations, and evolving management strategies.</p><p><strong>Recent findings: </strong>Despite high prevalence, osteoporosis remains underdiagnosed and undertreated in surgical candidates, with preoperative bone mineral density (BMD) screening often overlooked. Recent evidence underscores the importance of optimizing bone health preoperatively through pharmacologic therapies, which includes bisphosphonates, denosumab, and anabolic agents like teriparatide and romosozumab. Furthermore, surgical innovations such as cement augmentation and biomechanically optimized pedicle screw techniques are thoroughly discussed. New modalities, such as CT-based Hounsfield unit assessments and finite element analysis, offer improved preoperative evaluation of bone quality. Successful spine surgery outcomes in osteoporotic patients require a multidisciplinary approach that integrates early screening, targeted pharmacologic treatment, lifestyle modifications, and advanced surgical planning. Addressing osteoporosis comprehensively improves implant fixation, reduces complications like pseudoarthrosis and junctional failures, and enhances overall patient quality of life.</p>","PeriodicalId":48750,"journal":{"name":"Current Osteoporosis Reports","volume":"23 1","pages":"41"},"PeriodicalIF":5.3000,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Osteoporosis Reports","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11914-025-00930-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0
Abstract
Purpose of review: Osteoporosis is a systemic skeletal disease that presents unique challenges in spine surgery due to decreased bone mass, poor bone quality, and increased risk of fractures. This review aims to synthesize current understanding of osteoporosis in the context of spinal procedures, emphasizing the pathophysiology, diagnostic challenges, perioperative considerations, and evolving management strategies.
Recent findings: Despite high prevalence, osteoporosis remains underdiagnosed and undertreated in surgical candidates, with preoperative bone mineral density (BMD) screening often overlooked. Recent evidence underscores the importance of optimizing bone health preoperatively through pharmacologic therapies, which includes bisphosphonates, denosumab, and anabolic agents like teriparatide and romosozumab. Furthermore, surgical innovations such as cement augmentation and biomechanically optimized pedicle screw techniques are thoroughly discussed. New modalities, such as CT-based Hounsfield unit assessments and finite element analysis, offer improved preoperative evaluation of bone quality. Successful spine surgery outcomes in osteoporotic patients require a multidisciplinary approach that integrates early screening, targeted pharmacologic treatment, lifestyle modifications, and advanced surgical planning. Addressing osteoporosis comprehensively improves implant fixation, reduces complications like pseudoarthrosis and junctional failures, and enhances overall patient quality of life.
期刊介绍:
This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of osteoporosis.
We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as current and future therapeutics, epidemiology and pathophysiology, and evaluation and management. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.