Neurospine

Basic Science

Romosozumab Enhances Implant Stability in Glucocorticoid-Induced Osteoporotic Bone: A Rabbit Model Study: Ji-Won Kwon, Seong-Hwan Moon, Kyung-Soo Suk, Si Young Park, Hak-Sun Kim, Sub-Ri Park, Namhoo Kim, Byung Ho Lee; Neurospine 2025;22(4):880-890. Published online December 31, 2025; DOI: https://doi.org/10.14245/ns.2550774.387

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Romosozumab Enhances Implant Stability in Glucocorticoid-Induced Osteoporotic Bone: A Rabbit Model Study

Neurospine. 2025;22(4):880-890. Published online December 31, 2025

DOI: https://doi.org/10.14245/ns.2550774.387

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Romosozumab Enhances Implant Stability in Glucocorticoid-Induced Osteoporotic Bone: A Rabbit Model Study

Neurospine. 2025;22(4):880-890. Published online December 31, 2025

DOI: https://doi.org/10.14245/ns.2550774.387

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Objective
Implant fixation in osteoporotic bone presents substantial challenges due to reduced bone mass and compromised microarchitecture. This study investigated whether romosozumab, a sclerostin inhibitor, improves osseointegration and mechanical stability of cancellous bone screws in glucocorticoid-induced osteoporosis.
Methods
Fifty-five New Zealand white rabbits were enrolled. Osteoporosis was induced via either bilateral ovariectomy or weekly intramuscular glucocorticoid injections (4–8 mg/kg). Based on bone mineral density results, glucocorticoid injection was selected for experimental induction. Rabbits were divided into 5 groups: control, untreated osteoporosis, parathyroid hormone (PTH), PTH combined with denosumab, and romosozumab. Cancellous bone screws (4.0-mm diameter, titanium alloy) were bilaterally inserted into the iliac bones. Antiosteoporosis treatments were administered for 3-week postimplantation. Histomorphometric evaluation of bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) was performed using nondecalcified sectioning and Goldner trichrome staining. Biomechanical pull-out testing measured resistance at 1-mm displacement using a standardized setup on the MTS system.
Results
The romosozumab-treated group exhibited superior outcomes. BIC reached 21.2%±18.1%, and BAFO was 56.9%±9.9%. Pull-out strength significantly increased to 275±55 N in the romosozumab group, outperforming PTH (184±61 N), PTH+denosumab (202±23 N), and untreated osteoporosis (120±33 N). Enhanced collagen structure and neobone formation were observed histologically around implants.
Conclusion
Romosozumab significantly enhances cancellous bone screw fixation strength and osseointegration in glucocorticoid-induced osteoporotic bone. These findings suggest its clinical potential as an adjuvant therapy in improving spinal implant outcomes in osteoporotic patients.

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Limited Impact of Short-Term Osteoporosis Medication on Vertebral Height Loss in the Acute Phase of Osteoporotic Vertebral Compression Fractures: A 3-Month Longitudinal Analysis
Jaehoon Kim, Bong-Ju Lee, Jae-Beom Bae, Sang-bum Kim, Dong-Hwan Kim, Ja-Yeong Yoon
Medicina.2026; 62(2): 299. CrossRef
Bone Bridge Effect for the Treatment of Acute Osteoporotic Vertebral Compression Fractures: A Multistrategic Approach Using an Anabolic Agent
Ja-Yeong Yoon, Sung-Min Kim, Seong-Hwan Moon, Hak-Sun Kim, Kyung-Soo Suk, Si-Young Park, Ji-Won Kwon, Byung Ho Lee
Yonsei Medical Journal.2026; 67(6): 492. CrossRef
Early Implant Fixation as a Clinically Important Endpoint – A Commentary on “Romosozumab Enhances Implant Stability in Glucocorticoid-Induced Osteoporotic Bone: A Rabbit Model Study”
Ji-Won Kwon, Byung Ho Lee
Neurospine.2026; 23(2): 510. CrossRef
A Commentary on “Romosozumab Enhances Implant Stability in Glucocorticoid-Induced Osteoporotic Bone: A Rabbit Model Study”
Bin Liu, Hongsheng Lin
Neurospine.2026; 23(2): 508. CrossRef
From the Editor-in-Chief: Featured Articles in the December 2025 Issue
Inbo Han
Neurospine.2025; 22(4): 877. CrossRef

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Trauma

Development and Validation of a Nomogram for Predicting Adjacent Vertebral Fracture After Osteoporotic Vertebral Compression Fracture Surgery: A Multicenter Retrospective Cohort Study: Hanwen Cheng, Huilong Wen, Yong Ma, Zhuojie Liu, Haoyu Wu, Lajing Luowu, Yong Xiao, Lianbin Liang, Fanjie Kong, Longyi Xiao, Chunhai Li; Neurospine 2025;22(2):592-602. Published online April 16, 2025; DOI: https://doi.org/10.14245/ns.2449338.669

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Development and Validation of a Nomogram for Predicting Adjacent Vertebral Fracture After Osteoporotic Vertebral Compression Fracture Surgery: A Multicenter Retrospective Cohort Study

Neurospine. 2025;22(2):592-602. Published online April 16, 2025

DOI: https://doi.org/10.14245/ns.2449338.669

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Development and Validation of a Nomogram for Predicting Adjacent Vertebral Fracture After Osteoporotic Vertebral Compression Fracture Surgery: A Multicenter Retrospective Cohort Study

Neurospine. 2025;22(2):592-602. Published online April 16, 2025

DOI: https://doi.org/10.14245/ns.2449338.669

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Objective
Osteoporotic vertebral compression fractures (OVCFs) are a major public health concern. While percutaneous vertebral augmentation (PVA) is an effective treatment for OVCF, adjacent vertebral fractures (AVF) often occur post-PVA, adversely affecting treatment outcomes. This study aims to develop a nomogram for predicting AVF risk using multicenter data to aid clinical decision-making for OVCF patients.
Methods
We retrospectively analyzed patients who underwent PVA at 3 hospitals between 2017 and 2022. The cohort was divided into a training set (80%) and a validation set (20%). Independent risk factors for AVF were identified using LASSO (least absolute shrinkage and selection operator) and logistic regression. Seven significant factors were: bone mineral density, diabetes, total fractured vertebrae, intravertebral vacuum cleft sign, recovery of local kyphosis angle, regular aerobic exercise, and lumbar brace use.
Results
Among the 483 patients, 52 (10.76%) developed adjacent vertebral refractures within 2 years. The nomogram demonstrated high predictive accuracy, with area under the curves of 89.21% in the training set and 98.33% in the validation set.
Conclusion
This pioneering nomogram, incorporating baseline, surgical, and postoperative factors, provides valuable guidance for spine surgeons in preoperative planning and postoperative management, enabling personalized prognosis and rehabilitation for OVCF patients.

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Risk Factors for Osteoporotic Vertebral Compression Fracture and Evaluation of Clinical Outcomes of Minimally Invasive Vertebral Augmentation
Zhuang Zhu, Ying Li, Jixiang Chen, Shuang Su, Ru Tao, Defeng Wang
Global Spine Journal.2026;[Epub] CrossRef
Prediction models for subsequent vertebral fractures after percutaneous vertebroplasty or kyphoplasty: a systematic review and critical appraisal
Linlin Zhang, Shuqiu Lin, Wenping Xue, Wei Wang, Yanling Zhou
BMC Musculoskeletal Disorders.2026;[Epub] CrossRef
The osteoporosis-fracture cascade: new insights into vertebral fracture prevalence and financial costs in China
Guoliang Ma, He Yin, Liguo Zhu
International Journal of Surgery.2025; 111(7): 4921. CrossRef

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Regular Issue

Utility of Radiographic Parameter in Assessing Bone Density and Subsequent Fractures in Patients With Osteoporotic Vertebral Compression Fracture: Yunsheng Wang, Mei Dong, Jiali Zhang, Dechao Miao, Feng Wang, Tong Tong, Linfeng Wang; Neurospine 2024;21(3):966-972. Published online September 30, 2024; DOI: https://doi.org/10.14245/ns.2448310.155

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Utility of Radiographic Parameter in Assessing Bone Density and Subsequent Fractures in Patients With Osteoporotic Vertebral Compression Fracture

Neurospine. 2024;21(3):966-972. Published online September 30, 2024

DOI: https://doi.org/10.14245/ns.2448310.155

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Utility of Radiographic Parameter in Assessing Bone Density and Subsequent Fractures in Patients With Osteoporotic Vertebral Compression Fracture

Neurospine. 2024;21(3):966-972. Published online September 30, 2024

DOI: https://doi.org/10.14245/ns.2448310.155

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Objective
To investigate the ability of radiological parameter canal bone ratio (CBR) to assess bone mineral density and to differentiate between patients with primary and multiple osteoporotic vertebral compression fracture (OVCF).
Methods
A retrospective analysis was conducted on OVCF patients treated at our hospital. CBR was measured through full-spine x-rays. Patients were categorized into primary and multiple fracture groups. Receiver operating characteristic curve analysis and area under the curve (AUC) calculation were used to assess the ability of parameters to predict osteoporosis and multiple fractures. Predictors of T values were analyzed by multiple linear regression, and independent risk factors for multiple fractures were determined by multiple logistic regression analysis.
Results
CBR showed a moderate negative correlation with dual-energy x-ray absorptiometry T values (r = -0.642, p < 0.01). Higher CBR (odds ratio [OR], -6.483; 95% confidence interval [CI], -8.234 to -4.732; p < 0.01) and lower body mass index (OR, 0.054; 95% CI, 0.023–0.086; p < 0.01) were independent risk factors for osteoporosis. Patients with multiple fractures had lower T values (mean ± standard deviation [SD]: -3.76 ± 0.73 vs. -2.83 ± 0.75, p < 0.01) and higher CBR (mean ± SD: 0.54 ± 0.07 vs. 0.46 ± 0.06, p < 0.01). CBR had an AUC of 0.819 in predicting multiple fractures with a threshold of 0.53. T values prediction had an AUC of 0.816 with a threshold of -3.45. CBR > 0.53 was an independent risk factor for multiple fractures (OR, 14.66; 95% CI, 4.97–43.22; p < 0.01).
Conclusion
CBR is negatively correlated with bone mineral density (BMD) and can be a novel opportunistic BMD assessment method. It is a simple and effective measurement index for predicting multiple fractures, with predictive performance not inferior to T values.

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Comparison of the Clinical Efficacy of Anabolic Agents and Bisphosphonates in the Patients With Osteoporotic Vertebral Fracture: Systematic Review and Meta-analysis of Randomized Controlled Trials: Ikchan Jeon, Sung Bae Park, Bong Ju Moon, Miyoung Choi, Sung Uk Kuh, Jongtae Kim; Neurospine 2024;21(2):416-429. Published online May 2, 2024; DOI: https://doi.org/10.14245/ns.2347256.628

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Comparison of the Clinical Efficacy of Anabolic Agents and Bisphosphonates in the Patients With Osteoporotic Vertebral Fracture: Systematic Review and Meta-analysis of Randomized Controlled Trials

Neurospine. 2024;21(2):416-429. Published online May 2, 2024

DOI: https://doi.org/10.14245/ns.2347256.628

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Comparison of the Clinical Efficacy of Anabolic Agents and Bisphosphonates in the Patients With Osteoporotic Vertebral Fracture: Systematic Review and Meta-analysis of Randomized Controlled Trials

Neurospine. 2024;21(2):416-429. Published online May 2, 2024

DOI: https://doi.org/10.14245/ns.2347256.628

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Objective
We investigated the clinical efficacy of anabolic agents compared with bisphosphonates (BPs) for the incidence of new osteoporotic vertebral fracture (OVF) and fracture healing of OVF in the patients with OVF via meta-analyses of randomized controlled trials (RCTs).
Methods
Electronic databases, including PubMed, Embase, and Cochrane Library were searched for published RCTs till December 2022. The RCTs that recruited participants with osteoporosis at high-/very high-risk of fracture (a history of osteoporotic vertebral or hip fracture) or fresh OVF were included in this study. We assessed the risk of bias on every included RCTs, estimated relative risk (RR) for the incidence of new OVF and fracture healing of OVF, and overall certainty of evidence. Meta-analyses were performed by Cochrane review manager (RevMan) ver. 5.3. Cochrane risk of bias 2.0 and GRADEpro/GDT were applied for evaluating methodological quality and overall certainty of evidence, respectively.
Results
Five hundred eighteen studies were screened, and finally 6 eligible RCTs were included in the analysis. In the patients with prevalent OVF, anabolic agents significantly reduced the incidence of new OVF (teriparatide and romosozumab vs. alendronate and risedronate [RR, 0.57; 95% confidence interval, 0.45–0.71; p < 0.00001; high-certainty of evidence]; teriparatide vs. risedronate [RR, 0.50; 95% confidence interval, 0.37–0.68; p < 0.0001; high-certainty of evidence]). However, there was no evidence of teriparatide compared to alendronate in fracture healing of OVF (RR, 1.23; 95% confidence interval, 0.95–1.60; p = 0.12; low-certainty of evidence).
Conclusion
In the patients with prevalent OVF, anabolic agents showed a significant superiority for preventing new OVF than BPs, with no significant evidence for promoting fracture healing of OVF. However, considering small number of RCTs in this study, additional studies with large-scale data are required to obtain more robust evidences.

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Development of an explainable machine learning model to reproduce and interpret expert pharmacological decisions in osteoporosis treatment
Yutaro Sugawara, Tomohiro Shimizu, Hotaka Ishizu, Kosuke Arita, Yusuke Ohashi, Shu Yamazaki, Terufumi Kokabu, Katsuhisa Yamada, Norimasa Iwasaki
Bone.2026; 204: 117745. CrossRef
Disuse Bone Loss in Fusion Constructs After Multilevel Lumbar Fusion: A Computed Tomography Hounsfield Unit Analysis
Hyun-Jun Jang, Dongkyu Kim, Bong-Ju Moon, Kyung-Hyun Kim, Jeong-Yoon Park, Sung-Uk Kuh, Keun-Su Kim, Dong-Kyu Chin
Neurospine.2026; 23(1): 176. CrossRef
Under-prescribed and underutilized: National trends in osteoporosis medication use after fragility fracture
Harsh Wadhwa, Katelin J. Isakoff, Nicole S. Pham, L. Henry Goodnough, Julius A. Bishop, Michael J. Gardner
Bone.2026; 206: 117835. CrossRef
Comparative Radiologic Outcomes of Romosozumab and Teriparatide in Osteoporotic Vertebral Fractures
Jun-Seok Lee, Geon-U Kim, Ho-Young Jung, Young-Hoon Kim, Sang-Il Kim, Sangjun Park, Young-Yul Kim, Hyung-Youl Park
Journal of Clinical Medicine.2026; 15(6): 2349. CrossRef
A Comparison Between Bisphosphonates and Teriparatide in the Treatment of Postmenopausal Osteoporosis: A Systematic Review
Russaal S Mann, Isha Chopra, Abdullah Kilic, Ayushi Saxena, Bilal Khan, Rupanshu Rupanshu, Paolo S Chavez Cavalie
Cureus.2026;[Epub] CrossRef
Sequential Versus Step-Therapy Approaches for Osteoporosis Management in Orthopedic Subspecialties
Samer G. Salman, Rohan Phadke, James Burnett, Jonathan Walsh
Current Osteoporosis Reports.2026;[Epub] CrossRef
Effectiveness of Posterior Long-Segment Fixation for Thoracolumbar Osteoporotic Compression Fractures: A Retrospective Study
Jong-Hwan Hong, Jong-Hoon Jung, Ji-Ho Jung, Moon-Soo Han, Jung-Kil Lee
World Neurosurgery.2025; 194: 123433. CrossRef
A Real-Life Study in Sequential Therapy for Severe Menopausal Osteoporosis
Oana-Claudia Sima, Mihai Costachescu, Mihaela Stanciu, Claudiu Nistor, Mara Carsote, Denisa Tanasescu, Florina Ligia Popa, Ana Valea
Journal of Clinical Medicine.2025; 14(2): 627. CrossRef
Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes
Hyun Woong Mun, Jong Joo Lee, Hyun Chul Shin, Tae-Hwan Kim, Seok Woo Kim, Jae Keun Oh
Neurospine.2025; 22(1): 69. CrossRef
A Commentary on “Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes”
Toshihiko Inui
Neurospine.2025; 22(1): 78. CrossRef
Clinical Outcomes and Risk Factors Associated with Spinal Kyphotic Deformity Following Osteoporotic Vertebral Fracture
Hayato Oishi, Keishi Maruo, Tomoyuki Kusukawa, Tetsuto Yamaura, Kazuma Nagao, Masakazu Toi, Masaru Hatano, Fumihiro Arizumi, Norichika Yoshie, Toshiya Tachibana
Journal of Clinical Medicine.2025; 14(8): 2769. CrossRef
Revisiting Cement Augmentation in Osteoporotic Vertebral Fractures: A Narrative Review
Gilbert Bungay Dimacali, Byung Ho Lee
Journal of Korean Society of Spine Surgery.2025; 32(4): 144. CrossRef
The Effects of Longer Use of Teriparatide on Clinical and Radiographic Outcomes after Spinal Fusion in Geriatric Patients
Young-Hoon Kim, Kee-Yong Ha, Hyun W. Bae, Hyung-Youl Park, Young-Il Ko, Myung-Sup Ko, Sang-Il Kim
Medicina.2024; 60(6): 946. CrossRef
From the Editor-in-Chief: Featured Articles in the June 2024 Issue
Inbo Han
Neurospine.2024; 21(2): 373. CrossRef
Commentary on “Comparison of the Clinical Efficacy of Anabolic Agents and Bisphosphonates in the Patients With Osteoporotic Vertebral Fracture: Systematic Review and Meta-analysis of Randomized Controlled Trials”
Dae-Chul Cho
Neurospine.2024; 21(2): 430. CrossRef

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Bone Biology and Osteoporosis Special Issue

Comparison of the Efficacy of Romosozumab and Teriparatide for the Management of Osteoporotic Vertebral Compression Fractures: Danbi Park, Seo Eun Kim, Hong Kyung Shin, Junghan Seo, Jeong Kyun Joo, Chongman Kim, Sang Hyub Lee, Jin Hoon Park; Neurospine 2023;20(4):1217-1223. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2347030.515

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Comparison of the Efficacy of Romosozumab and Teriparatide for the Management of Osteoporotic Vertebral Compression Fractures

Neurospine. 2023;20(4):1217-1223. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2347030.515

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Comparison of the Efficacy of Romosozumab and Teriparatide for the Management of Osteoporotic Vertebral Compression Fractures

Neurospine. 2023;20(4):1217-1223. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2347030.515

Close

Objective
Romosozumab is increasingly employed to manage osteoporosis. However, no studies have analyzed its effects on recent osteoporotic vertebral compression fractures (OVCFs). Therefore, this study aimed to evaluate the efficacy of romosozumab compared with teriparatide in managing OVCFs.
Methods
The electronic medical records of postmenopausal patients with recent OVCFs who were administered romosozumab or teriparatide for one year from March 2018 to August 2022 were retrospectively reviewed. We compared the 2 groups for demographics, radiological outcomes (compression ratio, Cobb angle, and bone mineral density [BMD]), and clinical outcomes (Numerical Rating Scale [NRS] for back pain).
Results
Fifty-five patients with OVCFs, 32 patients treated with romosozumab and 23 with teriparatide, were included in this study. The change of BMD (g/cm²) values was significantly higher (p = 0.016) in the romosozumab (0.04 ± 0.06) than in the teriparatide group (0.00 ± 0.08) in the femur total. Furthermore, in subgroup analysis, the change of BMD (g/cm²) values in the lumbar spine was significantly higher (p = 0.016) in the romosozumab (0.12 ± 0.06) than in the teriparatide group (0.07 ± 0.06) in the lumbar spine. The decrease in NRS was significantly higher (p = 0.013) in the romosozumab (6.6 ± 2.0) than in the teriparatide group (5.5 ± 2.1). However, there was no significant difference in radiologic outcomes between the 2 groups.
Conclusion
Our findings suggest that romosozumab may be more effective than teriparatide in treating OVCFs in postmenopausal females, particularly in improving BMD and reducing back pain as measured by NRS.

Citations

Citations to this article as recorded by

Romosozumab mitigates progression from radiological to symptomatic adjacent-level fractures compared to teriparatide
Wei-Han Kao, Yi-Shan Yang, Chen-Ling Lan, Wen-Cheng Lo, Yung-Hsiao Chiang, Jiann-Her Lin
Osteoporosis International.2026; 37(2): 491. CrossRef
Comparative Radiologic Outcomes of Romosozumab and Teriparatide in Osteoporotic Vertebral Fractures
Jun-Seok Lee, Geon-U Kim, Ho-Young Jung, Young-Hoon Kim, Sang-Il Kim, Sangjun Park, Young-Yul Kim, Hyung-Youl Park
Journal of Clinical Medicine.2026; 15(6): 2349. CrossRef
Effectiveness of Posterior Long-Segment Fixation for Thoracolumbar Osteoporotic Compression Fractures: A Retrospective Study
Jong-Hwan Hong, Jong-Hoon Jung, Ji-Ho Jung, Moon-Soo Han, Jung-Kil Lee
World Neurosurgery.2025; 194: 123433. CrossRef
Off-label use of teriparatide for the treatment of a vertebral burst fracture in a young patient: A case report and literature review
Tiziano Villa, Vincenzo Zottola, Carlo Mariani, Alberto Borgonovo, Luciano Redenti
Trauma Case Reports.2025; 55: 101127. CrossRef
Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes
Hyun Woong Mun, Jong Joo Lee, Hyun Chul Shin, Tae-Hwan Kim, Seok Woo Kim, Jae Keun Oh
Neurospine.2025; 22(1): 69. CrossRef
A Commentary on “Comparative Analysis of Romosozumab Versus Vertebroplasty With Denosumab: Efficacy, Safety, and Secondary Bone Mineral Density Outcomes”
Toshihiko Inui
Neurospine.2025; 22(1): 78. CrossRef
Comparing the Efficacy of Antiosteoporotic Drugs in Preventing Periprosthetic Bone Loss Following Total Hip Arthroplasty: A Systematic Review and Bayesian Network Meta‐Analysis
Yi Tang, Zhaokai Jin, Yichen Lu, Lei Chen, Shuaijie Lv, Taotao Xu, Peijian Tong, Guoqian Chen
Orthopaedic Surgery.2024; 16(10): 2344. CrossRef
Commentary on “Deep Learning-Assisted Quantitative Measurement of Thoracolumbar Fracture Features on Lateral Radiographs”
Chao-Hung Kuo
Neurospine.2024; 21(1): 44. CrossRef
Comparison of osteoanabolic agents (teriparatide and romosozumab) with bisphosphonates in prevention of subsequent vertebral fractures in patients treated for osteoporotic vertebral fracture for 12 months: An observational cohort study
Keishi Maruo, Tomoyuki Kusukawa, Masakazu Toi, Tetsuto Yamaura, Masaru Hatano, Hayato Oishi, Kazuma Nagao, Fumihiro Arizumi, Kazuya Kishima, Norichika Yoshie, Toshiya Tachibana
Bone Reports.2024; 21: 101762. CrossRef
Incidence and Risk Factors of Sacral Fracture Following Lumbosacral Fusion for Degenerative Spinal Stenosis with a Minimum Follow-Up of 2 Years: A Case–Control Study
Sang Hyub Lee, Dong-Hwan Kim, Jin Hoon Park, Dong-Geun Lee, Choon Keun Park, Dong Ho Kang
World Neurosurgery.2024; 191: e633. CrossRef

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Bone Biology and Osteoporosis Special Issue

Which Indicator Among Lumbar Vertebral Hounsfield Unit, Vertebral Bone Quality, or Dual-Energy X-Ray Absorptiometry-Measured Bone Mineral Density Is More Efficacious in Predicting Thoracolumbar Fragility Fractures?: Bo Zhang, Lu-Ping Zhou, Xian-Liang Zhang, Dui Li, Jia-Qi Wang, Chong-Yu Jia, Hua-Qing Zhang, Liang Kang, Ren-Jie Zhang, Cai-Liang Shen; Neurospine 2023;20(4):1193-1204. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2346998.499

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Which Indicator Among Lumbar Vertebral Hounsfield Unit, Vertebral Bone Quality, or Dual-Energy X-Ray Absorptiometry-Measured Bone Mineral Density Is More Efficacious in Predicting Thoracolumbar Fragility Fractures?

Neurospine. 2023;20(4):1193-1204. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346998.499

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Which Indicator Among Lumbar Vertebral Hounsfield Unit, Vertebral Bone Quality, or Dual-Energy X-Ray Absorptiometry-Measured Bone Mineral Density Is More Efficacious in Predicting Thoracolumbar Fragility Fractures?

Neurospine. 2023;20(4):1193-1204. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346998.499

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Objective
Hounsfield units (HU), vertebral bone quality (VBQ), and bone mineral density (BMD) can all serve as predictive indicators for thoracolumbar fragility fractures. This study aims to explore which indicator provides better risk prediction for thoracolumbar fragility fractures.
Methods
Patients who have received medical attention from The First Affiliated Hospital of Anhui Medical University for thoracolumbar fragility fractures were selected. A total of 78 patients with thoracolumbar fragility fractures were included in the study. To establish a control group, 78 patients with degenerative spinal diseases were matched to the fracture group on the basis of gender, age, and body mass index. The lumbar vertebral HU, the VBQ, and the BMD were obtained for all the 156 patients through computed tomography, magnetic resonance imaging, and dual-energy x-ray absorptiometry (DEXA). The correlations among these parameters were analyzed. The area under curve (AUC) analysis was employed to assess the predictive efficacy and thresholds of lumbar vertebral HU, VBQ, and BMD in relation to the risk of thoracolumbar fragility fractures.
Results
Among the cohort of 156 patients, lumbar vertebral HU exhibited a positive correlation with BMD (p < 0.01). Conversely, VBQ showed a negative correlation with HU, BMD (p < 0.05). HU and BMD displayed a favorable predictive efficacy for thoracolumbar fragility fractures (p < 0.01), with HU (AUC = 0.863) showcasing the highest predictive efficacy, followed by the DEXA-measured BMD (AUC = 0.813). VBQ (AUC = 0.602) ranked lowest among the 3 indicators. The thresholds for predicting thoracolumbar fragility fractures were as follows: HU (88),VBQ (3.37), and BMD (0.81).
Conclusion
All 3 of these indicators, HU, VBQ, and BMD, can predict thoracolumbar fragility fractures. Notably, lumbar vertebral HU exhibits the highest predictive efficacy, followed by the BMD obtained through DEXA scanning, with VBQ demonstrating the lowest predictive efficacy.

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Bone Remodeling and Modeling: Cellular Targets for Antiresorptive and Anabolic Treatments, Including Approaches Through the Parathyroid Hormone (PTH)/PTH-Related Protein Pathway: Thomas John Martin, Ego Seeman; Neurospine 2023;20(4):1097-1109. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2346966.483

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Bone Remodeling and Modeling: Cellular Targets for Antiresorptive and Anabolic Treatments, Including Approaches Through the Parathyroid Hormone (PTH)/PTH-Related Protein Pathway

Neurospine. 2023;20(4):1097-1109. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346966.483

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Bone Remodeling and Modeling: Cellular Targets for Antiresorptive and Anabolic Treatments, Including Approaches Through the Parathyroid Hormone (PTH)/PTH-Related Protein Pathway

Neurospine. 2023;20(4):1097-1109. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346966.483

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Bone is continuously in a state of building and renewal, though the process of remodeling that takes place at many sites asynchronously throughout the skeleton, with bone formation and resorption equal at these sites (bone multicellular units). Remodeling takes place on bone surfaces, both on trabeculae and in the cortex, and serves the purposes of replacing old bone or that damaged by microfractures throughout the skeleton. The bone loss and consequent osteoporotic fractures that result from excess resorption over formation have mainly been prevented or treated by antiresorptive drugs that inhibit osteoclast formation and/or activity. Virtually all of the evidence leading to acceptance of antiresorptive drugs as treatment has depended upon their prevention of vertebral fractures. In recent decades, new prospects came of anabolic treatments that partly restore bone volume and microstructure restore bone that has been lost. The first of these was parathyroid hormone (PTH), shown by daily injection to increase markers of bone formation and prevent fractures. This field of interest enlarged with the discovery of PTH-related protein (PTHrP), so closely related in structure and action to PTH. The structural relationship between PTH and PTHrP is important in assessing their physiological and pharmacological roles, with the N-terminal domains of the 2 having virtually equal actions on target cells. Abaloparatide, a peptide analogue based on the structures of PTHrP and PTH, has been approved in some countries as a therapy for osteoporosis. Treatment through the PTH receptor activation pathway, and probably with any anabolic therapy, needs to be followed by antiresorptive treatment in order to maintain bone that has been restored. No matter how effective anabolic therapies for the skeleton become, it seems highly likely that there will be a continuing need for antiresorptive drugs.

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Bone Biology and Osteoporosis Special Issue

Treatment for Osteoporotic Vertebral Fracture - A Short Review of Orthosis and Percutaneous Vertebroplasty and Balloon Kyphoplasty: Masahiro Kawanishi, Hidekazu Tanaka, Yutaka Ito, Makoto Yamada, Kunio Yokoyama, Akira Sugie, Naokado Ikeda; Neurospine 2023;20(4):1124-1131. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2346936.468

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Treatment for Osteoporotic Vertebral Fracture - A Short Review of Orthosis and Percutaneous Vertebroplasty and Balloon Kyphoplasty

Neurospine. 2023;20(4):1124-1131. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346936.468

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Treatment for Osteoporotic Vertebral Fracture - A Short Review of Orthosis and Percutaneous Vertebroplasty and Balloon Kyphoplasty

Neurospine. 2023;20(4):1124-1131. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346936.468

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The management of osteoporotic vertebral fractures (OVFs) in the elderly includes nonoperative treatment and vertebroplasty, but has not been established due to the diversity of patient backgrounds. The purpose of this study was to compare the impact of 3 treatment modalities for the management of OVF: orthotic treatment, percutaneous vertebroplasty (PVP), and balloon kyphoplasty (BKP). The method was based on an analysis of the latest RCTs, meta-analyses, and systematic reviews on these topics. No study showed a benefit of bracing with high level of evidence. Trials were found that showed comparable outcomes without orthotic treatment. Only 1 randomized controlled trial (RCT) showed an improvement in pain relief up to 6 months compared with no orthosis. Rigid and nonrigid orthoses were equally effective. Four of 5 RCTs comparing vertebroplasty and sham surgery were equally effective, and one RCT showed superior pain relief with vertebroplasty within 3 weeks of onset. In open trials comparing vertebroplasty with nonoperative management, vertebroplasty was superior. PVP and BKP were comparable in terms of pain relief, improvement in quality of life, and adjacent vertebral fractures. BKP does not affect global sagittal alignment, although BKP may restore vertebral body height. An RCT was published showing that PVP was effective in chronic cases without pain relief. Vertebroplasty improved life expectancy by 22% at 10 years. The superiority of orthotic therapy for OVF was seen only in short-term pain relief. Soft orthoses proved to be a viable alternative to rigid orthoses. Vertebroplasty within 3 weeks may be useful. There is no significant difference in clinical efficacy between PVP and BKP. Vertebroplasty improves life expectancy.

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Bone Biology and Osteoporosis Special Issue

Utilization of Vertebroplasty/Kyphoplasty in the Management of Compression Fractures: National Trends and Predictors of Vertebroplasty/Kyphoplasty: Brannan E. O’Neill, Jamila A. Godil, Spencer Smith, Ali I. Rae, Christina H. Wright, James M. Wright, Donald A. Ross, Josiah N. Orina, Jesse J. Liu, Clifford Lin, Travis C. Philipp, Jonathan Kark, Jung U. Yoo, Won Hyung A. Ryu; Neurospine 2023;20(4):1132-1139. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2346804.402

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Utilization of Vertebroplasty/Kyphoplasty in the Management of Compression Fractures: National Trends and Predictors of Vertebroplasty/Kyphoplasty

Neurospine. 2023;20(4):1132-1139. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346804.402

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Utilization of Vertebroplasty/Kyphoplasty in the Management of Compression Fractures: National Trends and Predictors of Vertebroplasty/Kyphoplasty

Neurospine. 2023;20(4):1132-1139. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346804.402

Close

Objective
The purpose of this study is to examine the utilization of kyphoplasty/vertebroplasty procedures in the management of compression fractures. With the growing elderly population and the associated increase in rates of osteoporosis, vertebral compression fractures have become a daily encounter for spine surgeons. However, there remains a lack of consensus on the optimal management of this patient population.
Methods
A retrospective analysis of 91 million longitudinally followed patients from 2016 to 2019 was performed using the PearlDiver Patient Claims Database. Patients with compression fractures were identified using International Classification of Disease, 10th Revision codes, and a subset of patients who received kyphoplasty/vertebroplasty were identified using Common Procedural Terminology codes. Baseline demographic and clinical data between groups were acquired. Multivariable regression analysis was performed to determine predictors of receiving kyphoplasty/vertebroplasty.
Results
A total of 348,457 patients with compression fractures were identified with 9.2% of patients receiving kyphoplasty/vertebroplasty as their initial treatment. Of these patients, 43.5% underwent additional kyphoplasty/vertebroplasty 30 days after initial intervention. Patients receiving kyphoplasty/vertebroplasty were significantly older (72.2 vs. 67.9, p < 0.05), female, obese, had active smoking status and had higher Elixhauser Comorbidity Index scores. Multivariable analysis demonstrated that female sex, smoking status, and obesity were the 3 strongest predictors of receiving kyphoplasty/vertebroplasty (odds ratio, 1.27, 1.24, and 1.14, respectively). The annual rate of kyphoplasty/vertebroplasty did not change significantly (range, 8%–11%).
Conclusion
The majority of vertebral compression fractures are managed nonoperatively. However, certain patient factors such as smoking status, obesity, female sex, older age, osteoporosis, and greater comorbidities are predictors of undergoing kyphoplasty/vertebroplasty.

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Bone Biology and Osteoporosis Special Issue

Therapeutic Prediction of Osteoporotic Vertebral Compression Fracture Using the AO Spine-DGOU Osteoporotic Fracture Classification and Classification-Based Score: A Single-Center Retrospective Observational Study: Koki Mitani, Toshiyuki Takahashi, Shinya Tokunaga, Tomoo Inoue, Ryo Kanematsu, Manabu Minami, Junya Hanakita; Neurospine 2023;20(4):1166-1176. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2346776.388

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Therapeutic Prediction of Osteoporotic Vertebral Compression Fracture Using the AO Spine-DGOU Osteoporotic Fracture Classification and Classification-Based Score: A Single-Center Retrospective Observational Study

Neurospine. 2023;20(4):1166-1176. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346776.388

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Therapeutic Prediction of Osteoporotic Vertebral Compression Fracture Using the AO Spine-DGOU Osteoporotic Fracture Classification and Classification-Based Score: A Single-Center Retrospective Observational Study

Neurospine. 2023;20(4):1166-1176. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346776.388

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Objective
The treatment of osteoporotic vertebral compression fractures (OVCFs) is based on their severity; however, an efficient prediction tool is lacking. We aimed to evaluate the validity of the osteoporotic fracture classification (OF classification) and scoring system (OF score) in predicting the treatment strategy for patients with OVCF, defined according to the Japanese criteria.
Methods
We retrospectively investigated 487 consecutive patients diagnosed with vertebral body fractures between January 2018 and December 2022. Only patients with their fresh vertebral fracture episode during the study period were included. Patients were classified into 3 groups: conservative treatment, balloon kyphoplasty (BKP), and open surgery. OF classification and OF scores were assessed for each patient.
Results
A total of 237 patients with OVCF were included. There were 127, 81, and 29 patients in the conservative, BKP, and open surgery groups, respectively. The OF score was significantly higher in the BKP and open surgery groups than in the conservative group (p < 0.001). Multivariate logistic regression analysis showed that antiosteoporotic drug use, OF classification, progressive deformity, neurological symptoms and mobilization were independent risk factors for operative treatment (all p < 0.001). Receiver operating characteristic analysis showed that the cutoff OF score for operative indication was 5.5, with a sensitivity of 91.9%, specificity of 56.5%, and area under the curve of 0.820 (95% confidence interval, 0.769–0.871).
Conclusion
The OF score identified patients who required operative treatment with a high degree of accuracy. This is especially important for ruling out patients who definitely require operative treatment.

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Effect of Kyphoplasty on Pain Control and Vertebral Restoration
Mustafa C. Kilinc, Baran C. Alpergin, Omer M. Ozpiskin, Eray S. Aktan, Ihsan Dogan
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Diagnosis and treatment of osteoporotic vertebral fractures
Martin Bibza, Michal Božík, Mário Malina, Boris Šteňo
Clinical Osteology.2026; 31(1): 55. CrossRef
Treatment and outcome of osteoporotic OF3 vertebral fractures: results from the prospective multicenter EOFTT study
Sebastian Katscher, Bernhard W. Ullrich, Felix C. Kohler, Philipp Schenk, Klaus J. Schnake, Georg Osterhoff, Max J. Scheyerer, Gregor Schmeiser, Martin Bäumlein, Michael Scherer, Michael Müller, Kai Sprengel, Katja Liepold, Simon Schramm, Christopher Baro
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Surgical Considerations in Osteoporotic Dorso-Lumbar Spine Fractures
Ram Chaddha, Gaurav Agrawal, Agnivesh Tikoo, Harsh Kotadia
Indian Journal of Orthopaedics.2025; 59(3): 368. CrossRef
Efficacy and safety of erector spinae plane block for the treatment of osteoporotic vertebral compressive fractures
Yinghong Ma
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Classification of Osteoporotic Vertebral Compression Fractures – Current Updates and How to Manage Them
Aditya Kasture, Abhay Nene, Priyank Patel
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Biomechanical Study of 3 Osteoconductive Materials Applied in Pedicle Augmentation and Revision for Osteoporotic Vertebrae: Allograft Bone Particles, Calcium Phosphate Cement, Demineralized Bone Matrix: Chongyu Jia, Renjie Zhang, Jiaqi Wang, Bo Zhang, Huaqing Zhang, Liang Kang, Luping Zhou, Cailiang Shen; Neurospine 2023;20(4):1407-1420. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2346760.380

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Biomechanical Study of 3 Osteoconductive Materials Applied in Pedicle Augmentation and Revision for Osteoporotic Vertebrae: Allograft Bone Particles, Calcium Phosphate Cement, Demineralized Bone Matrix

Neurospine. 2023;20(4):1407-1420. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346760.380

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Biomechanical Study of 3 Osteoconductive Materials Applied in Pedicle Augmentation and Revision for Osteoporotic Vertebrae: Allograft Bone Particles, Calcium Phosphate Cement, Demineralized Bone Matrix

Neurospine. 2023;20(4):1407-1420. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346760.380

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Objective
This study assessed biomechanical properties of pedicle screws enhanced or revised with 3 materials. We aimed to compare the efficacy of these materials in pedicle augmentation and revision.
Methods
One hundred twenty human cadaveric vertebrae were utilized for in vitro testing. Vertebrae bone density was evaluated. Allograft bone particles (ABP), calcium phosphate cement (CPC), and demineralized bone matrix (DBM) were used to augment or revise pedicle screw. Post the implantation of pedicle screws, parameters such as insertional torque, pullout strength, cycles to failure and failure load were measured using specialized instruments.
Results
ABP, CPC, and DBM significantly enhanced biomechanical properties of the screws. CPC augmentation showed superior properties compared to ABP or DBM. ABP-augmented screws had higher cycles to failure and failure loads than DBM-augmented screws, with no difference in pullout strength. CPC-revised screws exhibited similar strength to the original screws, while ABP-revised screws showed comparable cycles to failure and failure loads but lower pullout strength. DBM-revised screws did not match the original screws’ strength.
Conclusion
ABP, CPC, and DBM effectively improve pedicle screw stability for pedicle augmentation. CPC demonstrated the highest efficacy, followed by ABP, while DBM was less effective. For pedicle revision, CPC is recommended as the primary choice, with ABP as an alternative. However, using DBM for pedicle revision is not recommended.

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Establishing and Validating Cervical and Lumbar Vertebral Bone Quality Thresholds for Predicting Mechanical Complications in Patients Undergoing Spinal Fusion: A Systematic Review and Meta-Analysis
Omar Lubbad, Akram Hagos, Yahya El-Tahlawy, Laila Lubbad, Giuseppe Lambros Morassi, Nektarios K. Mazarakis
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Hendrik Schöllmann, Veronika Weichert, Claas Neidlein, Nikolaus Brinkmann, Marcel Dudda, Eva Steinhausen
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The Combined Effects of RhBMP-2 and Systemic RANKL Inhibitor in Patients With Bone Density Loss Undergoing Posterior Lumbar Interbody Fusion: A Retrospective Observational Analysis With Propensity Score Matching: Seungjun Ryu, Seon-Jin Yoon, Chang Kyu Lee, Seong Yi, Keung-Nyun Kim, Yoon Ha, Dong Ah Shin; Neurospine 2023;20(4):1186-1192. Published online December 31, 2023; DOI: https://doi.org/10.14245/ns.2346702.351

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The Combined Effects of RhBMP-2 and Systemic RANKL Inhibitor in Patients With Bone Density Loss Undergoing Posterior Lumbar Interbody Fusion: A Retrospective Observational Analysis With Propensity Score Matching

Neurospine. 2023;20(4):1186-1192. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346702.351

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The Combined Effects of RhBMP-2 and Systemic RANKL Inhibitor in Patients With Bone Density Loss Undergoing Posterior Lumbar Interbody Fusion: A Retrospective Observational Analysis With Propensity Score Matching

Neurospine. 2023;20(4):1186-1192. Published online December 31, 2023

DOI: https://doi.org/10.14245/ns.2346702.351

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Objective
The risks of nonunion and subsidence are high in patients with bone density loss undergoing spinal fusion surgery. The internal application of recombinant human bone morphogenic protein 2 (rhBMP-2) in an interbody cage improves spinal fusion; however, related complications have been reported. Denosumab, a human monoclonal antibody targeting the receptor activator of nuclear factor kappa B ligand (RANKL), hinders osteoblast differentiation and function. Therefore, this study aimed to observe the combined effect of the local application of rhBMP-2 in a lumbar cage and systemic RANKL inhibition on postoperative spinal fusion in patients with bone density loss undergoing posterior lumbar interbody fusion (PLIF).
Methods
This retrospective observational study included 251 consecutive patients with spinal stenosis who underwent PLIF at a single center between 2017 and 2021. Clinical outcomes were assessed, and radiographic evaluations included lumbar flexion, extension, range of motion, and subsidence. Statistical analyses were conducted to identify the combined effect of the treatment and the subsidence and spinal fusion status.
Results
One hundred patients were included in the final analysis. Denosumab treatment significantly reduced the rate of osteolysis (p = 0.013). When denosumab was administered in combination with rhBMP-2, the fusion status remained similar; however, the incidences of postoperative osteolysis and postoperative oozing day decreased.
Conclusion
The combined use of rhBMP-2 and RANKL inhibition in patients with bone density loss can enhance bone formation after PLIF with fewer complications than rhBMP-2 alone.

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Yunsheng Wang, Ruiling Wang, Tong Tong, Dechao Miao, Feng Wang, Linfeng Wang
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Berik Tuleubayev, Yevgeniy Kamyshanskiy, Yerkin-Dauir Kurmangaliyev, Amina Koshanova, Ivan Avromidi, Yekaterina Kossilova, Daryn Darybayev
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Comparable Fusion Response, but Increased Inflammatory Response, with Escherichia coli-Derived Recombinant Human Bone Morphogenetic Protein-2 in Posterior Lumbar Interbody Fusion Surgery
Mu Ha Lee, Hyun Jun Jang, Kyung Hyun Kim, Jeong-Yoon Park, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim, Jae Keun Oh, Bong Ju Moon
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Comparison of Hounsfield Unit, Vertebral Bone Quality, and Dual-Energy X-Ray Absorptiometry T-Score for Predicting Cage Subsidence After Posterior Lumbar Interbody Fusion
Yunsheng Wang, Jiali Zhang, Tong Tong, Dechao Miao, Feng Wang, Linfeng Wang
Global Spine Journal.2025; 15(4): 2226. CrossRef
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HyungSub Jin, HyungJu Jin, Kyung-Soo Suk, Byung Ho Lee, Si Young Park, Hak-Sun Kim, Seong-Hwan Moon, Sub-Ri Park, Namhoo Kim, Jae Won Shin, Ji-Won Kwon
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Jun Ho Lee, Ji Hyun Youn, Hyun Jung Park, Seung-Jae Hyun
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Promotion of Bone Formation in a Rat Osteoporotic Vertebral Body Defect Model via Suppression of Osteoclastogenesis by Ectopic Embryonic Calvaria Derived Mesenchymal Stem Cells
Yerin Yu, Somin Lee, Minsung Bock, Seong Bae An, Hae Eun Shin, Jong Seop Rim, Jun-oh Kwon, Kwang-Sook Park, Inbo Han
International Journal of Molecular Sciences.2024; 25(15): 8174. CrossRef
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Biomechanical and Anatomical Validity of the Short Posterior Arch Screw: Jun Mizutani, Nozomu Inoue, Yoshihisa Otsuka, Aiharu Furuya, Alejandro A. Espinoza Orias, Takanobu Otsuka; Neurospine 2019;16(2):347-353. Published online October 14, 2018; DOI: https://doi.org/10.14245/ns.1836156.078

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Biomechanical and Anatomical Validity of the Short Posterior Arch Screw

Neurospine. 2019;16(2):347-353. Published online October 14, 2018

DOI: https://doi.org/10.14245/ns.1836156.078

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Biomechanical and Anatomical Validity of the Short Posterior Arch Screw

Neurospine. 2019;16(2):347-353. Published online October 14, 2018

DOI: https://doi.org/10.14245/ns.1836156.078

Close

Objective
This study was conducted to clarify the validity of the short posterior arch screw (S-PAS). The S-PAS is inserted only in the pedicle-analogue portion of the posterior arch. The S-PAS screw length is almost half that conventional C1 lateral mass screws inserted via the posterior arch (via-PAS). S-PAS reduces the risk of vertebral artery injury (VAI) because it never reaches the transverse foramen. Although the biomechanical validity of various C1 lateral mass screws (C1LMS) analyzed in young specimens have been published, that of unicortically inserted C1LMS such as the unicortical Harms screw, S-PAS, and via-PAS for elderly patients is concerning because of the high prevalence of osteoporosis in the elderly.
Methods
Nine fresh frozen cadavers (average age at death, 72.1 years) were used for pullout testing. The bone mineral density of each specimen was evaluated using quantitative computed tomography.
Results
The pullout strength of via-PAS (1,048.5 N) was significantly greater than that of the unicortical Harms screw (257.9 N) (p<0.05). The pullout strength of S-PAS was 720.3 N, which was also significantly greater than that of the unicortical Harms screw (p<0.05).
Conclusion
The via-PAS and S-PAS are valid surgical options, even in elderly patients. Along with sufficient biomechanical strength, the S-PAS screw prevents VAI.

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Safety and efficacy of Wharton's jelly-derived mesenchymal stem cells with teriparatide for osteoporotic vertebral fractures: A phase I/IIa study
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Tae-Keun Ahn, Kyoung-Tae Kim, Hari Prasad Joshi, Kwang Hwan Park, Jae Won Kyung, Un-Yong Choi, Seil Sohn, Seung-Hun Sheen, Dong-Eun Shin, Soo-Hong Lee, In-Bo Han
International Journal of Molecular Sciences.2020; 21(12): 4274. CrossRef

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The Therapeutic Effects of Combination Therapy with Curcumin and Alendronate on Spine Fusion Surgery in the Ovariectomized Rats: Dae-Chul Cho, Kyoungsu Ryu, Kyoung-Tae Kim, Joo-Kyung Sung; Korean J Spine 2017;14(2):35-40. Published online June 30, 2017; DOI: https://doi.org/10.14245/kjs.2017.14.2.35

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The Therapeutic Effects of Combination Therapy with Curcumin and Alendronate on Spine Fusion Surgery in the Ovariectomized Rats

Korean J Spine. 2017;14(2):35-40. Published online June 30, 2017

DOI: https://doi.org/10.14245/kjs.2017.14.2.35

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The Therapeutic Effects of Combination Therapy with Curcumin and Alendronate on Spine Fusion Surgery in the Ovariectomized Rats

Korean J Spine. 2017;14(2):35-40. Published online June 30, 2017

DOI: https://doi.org/10.14245/kjs.2017.14.2.35

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Objective
The purpose of this study was to evaluate the therapeutic effects of combination therapy with curcumin and alendronate on spine fusion surgery in ovariectomized rats. Methods: Thirty-two female Sprague-Dawley rats (12 weeks old) underwent bilateral ovariectomy (OVX). Eight weeks after surgery, animals underwent intertransverse spine fusion at L4-5. The rats were randomly distributed amongst 4 groups; untreated OVX group, curcumin administered group, alendronate administered group, and the combination therapy group. At 8 weeks after fusion surgery, the animals were sacrificed and the fusion mass was assessed by manual palpation, radiographic scan, and micro-computed tomographic scan. In addition, mechanical strength was determined by a 3-point bending test. Results: Based on the results of manual palpation testing and 3-dimensional micro-computed tomography scanning, solid bone fusion rate was 50% (4 of 8) in the OVX group, 75% (6 of 8) in the alendronate-only and curcumin-only group, and 87.5% (7 of 8) in the combination therapy group, respectively. The combination therapy group had a higher fusion rate compared with the other treatment groups, though not statistically significantly (p>0.05). And the combination therapy group had a significant increase in fusion volume at 8 weeks after spine fusion surgery compared with curcumin-only group (p=0.039). The 3-point bending test showed that combination therapy group had a significantly greater maximal load value compared to that of curcumin-only group (p=0.024). Conclusion: The present study demonstrated that additional treatment of curcumin and alendronate after spine fusion surgery in rat can promote higher fusion volume, and improve bone mechanical strength.

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Balloon Kyphoplasty: An Effective Treatment for Kummell Disease?: Pius Kim, Seok Won Kim; Korean J Spine 2016;13(3):102-106. Published online September 30, 2016; DOI: https://doi.org/10.14245/kjs.2016.13.3.102

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Balloon Kyphoplasty: An Effective Treatment for Kummell Disease?

Korean J Spine. 2016;13(3):102-106. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.102

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Citation and abstract for the content below

Balloon Kyphoplasty: An Effective Treatment for Kummell Disease?

Korean J Spine. 2016;13(3):102-106. Published online September 30, 2016

DOI: https://doi.org/10.14245/kjs.2016.13.3.102

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Objective

The purpose of this study was to evaluate the efficacy of balloon kyphoplasty for treating Kummel disease accompanying severe osteoporosis.

Methods

Twelve patients with single-level Kummell disease accompanied by severe osteoporosis were enrolled in this investigation. After postural reduction for 1 or 2 days, balloon kyphoplasty was performed on the collapsed vertebrae. Clinical results, radiological parameters, and related complications were assessed at 7 days, 1 month and 6 months after the procedure.

Results

Prior to kyphoplasty, the mean pain score (according to the visual analogue scale) was 8.0. Seven days after the procedure, this score improved to 2.5. Despite the significant improvement compared to preoperative value, the score increased to 4.0 at 6 months after the procedure. The mean preoperative vertebral height loss was 55.4%. Kyphoplasty reduced this loss to 31.6%, but it increased to 38.7% at 6 months after the procedure. The kyphotic angle improved significantly from 22.4°±4.9° (before the procedure) to 10.1°±3.8° after surgery, However, the improved angle was not maintained 6 months after the procedure. The mean correction loss for the kyphotic deformity was 7.2° at 6 months after the procedure. Three out of 12 patients sustained adjacent fractures after balloon kyphoplasty within 6 months.

Conclusion

Although balloon kyphoplasty for treating Kummell disease is known to provide stabilization and pain relief, it may be associated with the development of adjacent fractures and aggravated kyphosis.

Citations

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