Abstract
This prospective study evaluated 60 reproductive-age and postmenopausal women with lumbar disc disease to demonstrate the short-term effects of lumbar disc surgery on bone mineral density (BMD). Lumbar BMD was measured preoperatively and 3 months postoperatively by dual-energy X-ray absorptiometry (DEXA). Surgery was performed at only one level (L3-L4) and consisted of partial hemilaminectomy, discectomy, and, if necessary, partial facetectomy. Before surgery, 50% of the patients had osteopenia, and 31.7% had osteoporosis. After surgery, BMD decreased 5.5% in L3 vertebrae (P=.07), 14% in L4 vertebrae (P=.003), and 4.6% in L1-L4 (P=.039). Six of 11 patients with normal BMD before surgery became osteopenic postoperatively; 9 of 30 women with osteopenia fulfilled criteria for osteoporosis after surgery. Reproductive-age and postmenopausal women undergoing surgery for lumbar disc disease are at risk of bone loss and should be spared an extensive procedure, which can further increase the amount of bone lost. All women for whom a surgical intervention is planned should be evaluated by DEXA preoperatively and postoperatively.
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References
Narayan P, Haid RW, Subach BR, et al. Effect of spinal disease on successful arthrodesis in lumbar pedicle screw fixation.J Neurosurg (Spine). 2002;97:277–280.
Bridwell KH, Sedgewick TA, O’Brien MF, et al. The role of fusion and instrumentation in the treatment of degenerative spondylolisthesis with spinal stenosis.J Spinal Dis. 1993;6:461–472.
Nork SE, Hu SS, Workman KL, et al. Patient outcomes after decompression and instrumented posterior spinal fusion for degenerative spondylolisthesis.Spine. 1999;24:561–569.
Kumano K, Hirabayashi S, Ogawa Y, Aota Y. Pedicle screws and bone mineral density.Spine. 1994;19:1157–1161.
Hasegawa K, Takahashi HE, Uchiyama S, et al. An experimental study of a combination method using a pedicle screw and laminar hook for the osteoporotic spine.Spine. 1997;22:958–962.
Halvorson TL, Kelley LA, Thomas KA, Whitecloud TS 3rd, Cook SD. Effects of bone mineral density on pedicle screw fixation.Spine. 1994;19:2415–2420.
Nakano M, Hirano N, Matsuura K, et al. Percutaneous transpedicular vertebroplasty with calcium phosphate cement in the treatment of osteoporotic vertebral compression and burst fractures.J Neurosurg (Spine). 2002;97:287–293.
Consensus Development Conference. Prophylaxis and treatment of osteoporosis.Am J Med. 1991;90:107–110.
Melton LJ, Atkinson EJ, O’Fallon WM, Wahner HW, Riggs BL. Long term fracture prediction by bone mineral assessed at different skeletal sites.J Bone Miner Res. 1993;8:1227–1233.
Kanis JA, Melton LJ, Christiansen C, Johston C, Khaltaev N. Perspective. The diagnosis of osteoporosis.J Bone Miner Res. 1994;9:1137–1141.
Gordon JD, Speroff L. Menopause and the perimenopausal transition. In: Gordon JD, Speroff L, eds.Handbook for Clinical Gynecologic Endocrinology and Infertility. Philadelphia: Lippincott Williams & Wilkins; 2002:313–314.
Assessment of Osteoporotic Fracture Risk and Its Application to Screening for Postmenopausal Osteoporosis. Report of a WHO Study Group. Geneva: WHO; 1994;843. WHO Technical Report Series.
Mosekilde L, Thomsen JS. Bone structure and function in relation to aging and the menopause. In: Wren BG, ed.Progress in the Management of the Menopause. New York: Parthenon Publishing; 1997:126–136.
Iwamoto J, Takeda T. Effect of surgical treatment on physical activity and bone resorption in patients with neurogenic intermittent claudication.J Orthop Sci. 2002;7:84–90.
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Erdogan, B., Bagis, T., Sen, O. et al. Effects of lumbar disc surgery on bone mineral density in women with lumbar disc disease. Adv Therapy 20, 114–120 (2003). https://doi.org/10.1007/BF02850258
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DOI: https://doi.org/10.1007/BF02850258