Tags

Type your tag names separated by a space and hit enter

Characterization of osteopenia/osteoporosis in adult scoliosis: does bone density affect surgical outcome?
Spine (Phila Pa 1976). 2011 Sep 15; 36(20):1652-7.S

Abstract

STUDY DESIGN

Retrospective study.

OBJECTIVE

The aim of this study is to validate the prevalence of low bone mineral density (BMD) in woman patients with adult scoliosis and to relate that to surgical treatment outcome. Despite reports of the high prevalence of low BMD among female with adolescent idiopathic, these findings have not been substantiated in any comprehensive review of adult scoliosis patients undergoing surgical treatment.

SUMMARY OF BACKGROUND DATA

It has been suggested that scoliosis may predispose to osteoporosis and that degenerative scoliosis could falsely elevate spinal BMD measurements with dual energy radiograph absorptiometry (DXA). The discordance between hip and spine BMD measurement using DXA has also been shown in previous cross-sectional study for adult population.

METHODS

A retrospective review of 176 women treated surgically for scoliosis. BMD of the lumbar spine and femoral neck were determined by DXA. Patients were categorized as follows: concordance (osteoporosis, osteopenia, or normal BMD on both sites), minor discordance (osteoporosis in one site and osteopenia in the other site), and major discordance (osteoporosis in one site and normal the other site). Body mass index (BMI), preoperative Cobb angle, fusion ratio, and complication were recorded. Statistical analysis included the Student t test, χ(2) test, regression coefficient test, and simple linear regression. P value was set at P < 0.05.

RESULTS

The mean age was 51 ± 12 years (26-82 years). The mean T score of the hip was -1.23 ± 0.89 and of the spine was -0.52 ± 1.57. Major discordance in BMD 7 (4%) points, minor discordance 68 (39%) points, and concordance was 101 (57%) points. There was moderate correlation between T score of hip and spine (R = 0.55P < 0.01). T score of the hip and of the spine showed 10.8% and 10.2% of the patients were osteoporotic. The mean Z score of the hip and of the spine showed comparable age and sex matched values. No correlation was observed between BMD and Cobb angle (R = 0.05, P = 0.464). The fusion rate was 93% and surgical complication rate was 14.9%. No significant correlation was observed between BMD and fusion (P = 0.80) complication (P = 0.13).

CONCLUSION

Comparable bone density exists among adult scoliosis patients with no correlation between BMD and curve magnitude, fusion and complication rates. The difference in BMD of the hip and of spine cannot be fully explained in the review. These results will guide in surgical planning, patient selection on the treatment options.

Authors+Show Affiliations

Adult and Pediatric Spine and Scoliosis Surgery, Hospital for Special Surgery, New York, NY, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21304426

Citation

Yagi, Mitsuru, et al. "Characterization of Osteopenia/osteoporosis in Adult Scoliosis: Does Bone Density Affect Surgical Outcome?" Spine, vol. 36, no. 20, 2011, pp. 1652-7.
Yagi M, King AB, Boachie-Adjei O. Characterization of osteopenia/osteoporosis in adult scoliosis: does bone density affect surgical outcome? Spine. 2011;36(20):1652-7.
Yagi, M., King, A. B., & Boachie-Adjei, O. (2011). Characterization of osteopenia/osteoporosis in adult scoliosis: does bone density affect surgical outcome? Spine, 36(20), 1652-7. https://doi.org/10.1097/BRS.0b013e31820110b4
Yagi M, King AB, Boachie-Adjei O. Characterization of Osteopenia/osteoporosis in Adult Scoliosis: Does Bone Density Affect Surgical Outcome. Spine. 2011 Sep 15;36(20):1652-7. PubMed PMID: 21304426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Characterization of osteopenia/osteoporosis in adult scoliosis: does bone density affect surgical outcome? AU - Yagi,Mitsuru, AU - King,Akilah B, AU - Boachie-Adjei,Oheneba, PY - 2011/2/10/entrez PY - 2011/2/10/pubmed PY - 2012/6/14/medline SP - 1652 EP - 7 JF - Spine JO - Spine VL - 36 IS - 20 N2 - STUDY DESIGN: Retrospective study. OBJECTIVE: The aim of this study is to validate the prevalence of low bone mineral density (BMD) in woman patients with adult scoliosis and to relate that to surgical treatment outcome. Despite reports of the high prevalence of low BMD among female with adolescent idiopathic, these findings have not been substantiated in any comprehensive review of adult scoliosis patients undergoing surgical treatment. SUMMARY OF BACKGROUND DATA: It has been suggested that scoliosis may predispose to osteoporosis and that degenerative scoliosis could falsely elevate spinal BMD measurements with dual energy radiograph absorptiometry (DXA). The discordance between hip and spine BMD measurement using DXA has also been shown in previous cross-sectional study for adult population. METHODS: A retrospective review of 176 women treated surgically for scoliosis. BMD of the lumbar spine and femoral neck were determined by DXA. Patients were categorized as follows: concordance (osteoporosis, osteopenia, or normal BMD on both sites), minor discordance (osteoporosis in one site and osteopenia in the other site), and major discordance (osteoporosis in one site and normal the other site). Body mass index (BMI), preoperative Cobb angle, fusion ratio, and complication were recorded. Statistical analysis included the Student t test, χ(2) test, regression coefficient test, and simple linear regression. P value was set at P < 0.05. RESULTS: The mean age was 51 ± 12 years (26-82 years). The mean T score of the hip was -1.23 ± 0.89 and of the spine was -0.52 ± 1.57. Major discordance in BMD 7 (4%) points, minor discordance 68 (39%) points, and concordance was 101 (57%) points. There was moderate correlation between T score of hip and spine (R = 0.55P < 0.01). T score of the hip and of the spine showed 10.8% and 10.2% of the patients were osteoporotic. The mean Z score of the hip and of the spine showed comparable age and sex matched values. No correlation was observed between BMD and Cobb angle (R = 0.05, P = 0.464). The fusion rate was 93% and surgical complication rate was 14.9%. No significant correlation was observed between BMD and fusion (P = 0.80) complication (P = 0.13). CONCLUSION: Comparable bone density exists among adult scoliosis patients with no correlation between BMD and curve magnitude, fusion and complication rates. The difference in BMD of the hip and of spine cannot be fully explained in the review. These results will guide in surgical planning, patient selection on the treatment options. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/21304426/Characterization_of_osteopenia/osteoporosis_in_adult_scoliosis:_does_bone_density_affect_surgical_outcome L2 - http://dx.doi.org/10.1097/BRS.0b013e31820110b4 DB - PRIME DP - Unbound Medicine ER -