Journal List > J Korean Soc Spine Surg > v.22(3) > 1076083

J Korean Soc Spine Surg. 2015 Sep;22(3):82-91. Korean.
Published online September 30, 2015.  https://doi.org/10.4184/jkss.2015.22.3.82
© Copyright 2015 Korean Society of Spine Surgery
The Effect of Teriparatide in Women with Osteoporosis after Lumbar Posterolateral Fusion or Posterior Lumbar Interbody Fusion
Jeong Ho Seo, M.D., Kyu Yeol Lee, M.D., Ph.D., and Min-Woo Kim, M.D.
Department of Orthopedic Surgery, College of Medicine, Dong A University, Korea.

Corresponding author: Kyu Yeol Lee, M.D. Department of Orthopedic Surgery, College of Medicine, Dong-A University, 1, Dongdaesin-dong 3-ga, Seo-gu, Busan 602-715, Korea. TEL: +82-51-240-2867, FAX: +82-51-243-9764, Email: gylee@dau.ac.kr
Received July 02, 2015; Revised July 03, 2015; Accepted July 28, 2015.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Study Design

Retrospective study.

Objectives

To investigate radiologic and clinical outcomes of teriparatide in women with osteoporosis after instrumented lumbar posterolateral fusion (PLF) or posterior lumbar interbody fusion (PLIF).

Summary of Literature Review

Teriparatide accelerated lumbar posterolateral fusion in women with postmenopausal osteoporosis.

Materials and Methods

Eighty-six women older than 65 years old with osteoporosis underwent PLF or PLIF with bone graft between Februar, 2011 ato May, 2012 pPatients were divided into four group: teriparatide group with local bone (A-1: 13 patients;, teriparatide group with composite bone (A-2: 27 patients; non-teriparatide group with local bone (B-1: 14 patients; and non-teriparatide group with composite bone (B-2: 32 patients). At 3, 6, and 12 months postoperatively, the Oswestry Disability Index (ODI), visual analog scale (VAS), fusion rate, and period of bone union were evaluated.

Results

VAS and ODI improved after surgery in all groups, but no significant differences were notell among the groupses Further, there was no significant difference among the groups for agef fusion level, and fusiops(p>0.05). Fusion rate was 94.44% in the A-1 group, 92.59% in the A-2 group, 79.17% in the B-1 group, and 76.92% in the B-2 group. Average period of bone union was 3.25 months, 3.65 months, 5.67 months, anand 5.65 months respectively. Fusion rate and average bone union time made no significant differeneen among the groups divided by graft materials (p>0.05). However, those in the teriparatide group were significantly superior to those in the non-teriparatide group (p<0.05).

Conclusions

In women with osteoporosis after PLF or PLIF with bonegraft, teriparatide showed superiority in the rate of fusion and the period of bone union.

Keywords: Teriparatide; Posterolateral fusion; Posterior lumbar interbody fusion; Osteoporosis; Parathyroid hormone

Figures


Fig. 1
At the six month follllow-w-up of the 73-year-old womanmanman with posterior lumbambambar fusion for spinalnalnal stenosis L4-L5, L5-S1, dynamic flexion (A) and extension (B) radiographs show less than 2° angular motion on L4-L5 after instrumentation without screw loosening.
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Fig. 2
CT scans 6 months after surgery from a 74-year-old woman who underwent posterolateral lumbar fusion of L3-L4, L4-L5 with composite bone graft of local bone and allograft. (A) An axial CT image shows big solid trabeculated bilateral fusion mass formation bilaterally on L4-L5. (B) A sagittal CT image of the same patient shows continuously sufficient trabecular bone formation in the right transverse processes of L3 to L5.
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Tables


Table 1
Demographic Characteristics of the Patients
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Table 2
Clinical Pain Scores of Patients
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Table 3
Multivariate Analysis
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Table 4
Tests of Between-Subjects Effect
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Table 5
Evaluation of Bone Union
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