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Bone Quality Linked to Complications After Spinal Fusion

TUESDAY, Jan. 5, 2021 -- Abnormalities of trabecular and cortical microarchitecture are associated with skeletal complications in the six months following spinal fusion surgery, according to a study published in the February issue of Bone.

Han Jo Kim, M.D., from the Hospital for Special Surgery in New York City, and colleagues used high resolution peripheral quantitative computed tomography (HR-pQCT) measurements of volumetric bone mineral density (vBMD) to examine preoperative bone quality as a risk factor for early postoperative complications in 54 individuals enrolled preoperatively and followed for six months after multilevel lumbar spine fusion.

The researchers found that 14 patients had skeletal complications. There was no difference noted between those with and without complications in baseline areal BMD and trabecular bone score by dual energy X-ray absorptiometry. However, patients who developed complications had lower trabecular vBMD, fewer and thinner trabeculae at both the radius and tibia, and thinner tibial cortices on HR-pQCT.

"These results help to provide a mechanism for early skeletal complications after fusion," the authors write. "They suggest that both trabecular and cortical bone make important contributions to the stability of inserted hardware, as well as the ability to withstand the modified loads of the new surgical construct, so that new bone can be formed."

Several authors disclosed financial ties to the pharmaceutical and medical device industries.

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Posted: January 2021

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