Nearly 200 million people worldwide have osteoporosis. There is limited accessible evidence on osteoporosis patients with short-segment lumbar fusion result in degenerative disc disease (DDD). For a study, researchers sought to determine if there was a link between osteoporosis and the probability of bad outcomes in DDD patients receiving short-segment lumbar fusion. All patients with DDD who had 2- to 3-level lumbar fusion from 2009 to 2011 were identified using the New York State Statewide Planning and Research Cooperative System. Patients with bone mineralization issues, other systemic and endocrine illnesses, surgical indications of trauma, systemic disease(s), or infection, were excluded. Patients were divided into two groups based on whether they had osteoporosis, and their demographics, hospital-related data, and 2-year complications and revision operations were compared. Multivariate binary logistic regression models were applied to discover significant complication predictors.
A total of 29,028 individuals were enrolled (osteoporosis = 1,353 [4.7%], nonosteoporosis = 27,675 [95.3%]). Patients with osteoporosis were older (66.9 vs. 52.6 years), more likely to be female (85.1 vs. 48.4%), and more likely to be White (82.8 vs. 73.5%) (all P<0.001). The Charlson/Deyo comorbidity index did not differ substantially among groups. Patients with osteoporosis had longer hospital stays and higher overall expenses (4.9 vs. 4.1 days; $74,484 vs. $73,724; both P<0.001). Medical complications, such as acute renal failure and deep-vein thrombosis, were more common in osteoporosis patients (both P<0.01). The group also showed a higher incidence of implant-related problems (3.4% vs. 1.9%) and wound complications (9.8% vs. 5.9%) (both P<0.01). Preoperative osteoporosis was highly linked to 2-year medical and surgical problems (odds ratios of 1.6 and 1.7, respectively), as well as a higher likelihood of revision surgery (odds ratio, 1.3) (both P<0.001).Patients with osteoporosis with a 2- to 3-level lumbar fusion for DDD had a greater risk of medical and surgical problems during the next two years, particularly implant-related and wound issues. The findings highlight the need for a thorough preoperative metabolic workup and patient optimization prior to spine surgery.
Reference:journals.lww.com/jaaos/Abstract/2022/06150/The_Impact_of_Osteoporosis_on_Adverse_Outcomes.5.aspx
