Mingbo WANG, Xianglong MENG, Yonggang LI, Yi FENG, Zhiqiang CHANG, Yong HAI

Effects of anti-osteoporosis treatment in the elderly with anterior cervical discectomy and fusion

Objective: The aim of this study was to evaluate the effect of anti-osteoporosis treatment on radiological and functional results following anterior cervical discectomy and fusion (ACDF).Methods: Medical records of 59 patients (Mean age 68.1 years, 36 males and 23 females) who had ACDF surgery between January 2010 and December 2013 were retrospectively reviewed. Antiosteoporotic treatment group consisted of 31 patients and non-antiosteoporotic treatment group consisted of 28 patients. The height of intervertebral space (HIS), cervical alignment (CA), segmental angle (SA), and Visual Analogue Scale (VAS) were compared between the groups, preoperatively, postoperatively, and at final follow-up.Results: There were significant differences at final follow-up between the 2 groups in SA (p=0.03), HIS (p=0.03), and VAS (p=0.03) for upper limb pain, in favor of antiosteoporotic treatment.Conclusion: Anti-osteoporotic treatment appear to improve the radiological and functional results following following anterior cervical discectomy and fusion

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Angevine PD, Arons RR, McCormick PC. National and regional rates and variation of cervical discectomy with and without anterior fusion, 1990-1999. Spine (Phila Pa 1976) 2003;28:931,40.

Bessette L, Ste-Marie LG, Jean S, Davison KS, Beaulieu M, Baranci M, et al. Recognizing osteoporosis and its con- sequences in Quebec (ROCQ): background, rationale, and methods of an anti-fracture patient health-management programme. Contemp Clin Trials 2008;29:194-210.

Bukata SV, Digiovanni BF, Friedman SM, Hoyen H, Kates A, Kates SL, et al. A guide to improving the care of pa- tients with fragility fractures. Geriatr Orthop Surg Rehabil 2011;2:5-37.

Varacallo MA, Fox EJ, Paul EM, Hassenbein SE, Warlow PM. Patients' response toward an automated orthopedic osteoporosis intervention program. Geriatr Orthop Surg Rehabil 2013;4:89-98.

Diab DL, Watts NB. Diagnosis and treatment of osteo- porosis in older adults. Endocrinol Metab Clin North Am 2013;42:305-17.

Cummings SR, Melton LJ. Epidemiology and outcomes of osteoporotic fractures. Lancet 2002;359:1761-7.

Mithal A, Bansal B, Kyer CS, Ebeling P. The Asia-Pacif- ic Regional Audit-Epidemiology, Costs, and Burden of Osteoporosis in India 2013: A report of International Osteoporosis Foundation. Indian J Endocrinol Metab 2014;18:449,54.

Ekman EF. The role of the orthopaedic surgeon in mini- mizing mortality and morbidity associated with fragility fractures. J Am Acad Orthop Surg 2010;18:278-85.

Johnell O, Kanis JA, Odén A, Sernbo I, Redlund-Johnell I, Petterson C, et al. Fracture risk following an osteoporotic fracture. Osteoporos Int 2004;15:175-9.

Bogoch ER, Elliot-Gibson V, Beaton DE, Jamal SA, Josse RG, Murray TM. Effective initiation of osteoporosis di- agnosis and treatment for patients with a fragility fracture in an orthopaedic environment. J Bone Joint Surg Am 2006;88:25-34.

Niu CC, Hai Y, Fredrickson BE, Yuan HA. Anterior cer- vical corpectomy and strut graft fusion using a different method. Spine J 2002;2:179-87.

Paxinos O, Ghanayem AJ, Zindrick MR, Voronov LI, Havey RM, Carandang G, et al. Anterior cervical discec- tomy and fusion with a locked plate and wedged graft ef- fectively stabilizes flexion-distraction stage-3 injury in the lower cervical spine: a biomechanical study. Spine (Phila Pa 1976) 2009;34:E9-15.

Lee CK, Vessa P, Lee JK. Chronic disabling low back pain syndrome caused by internal disc derangements. The re- sults of disc excision and posterior lumbar interbody fu- sion. Spine (Phila Pa 1976) 1995;20:356-61.

Jiang SD, Jiang LS, Dai LY. Anterior cervical discectomy and fusion versus anterior cervical corpectomy and fusion for multilevel cervical spondylosis: a systematic review. Arch Orthop Trauma Surg 2012;132:155-61.

Lin H, Bao LH, Zhu XF, Qian C, Chen X, Han ZB. Analysis of recurrent fracture of a new vertebral body after percutaneous vertebroplasty in patients with osteoporosis. Orthop Surg 2010;2:119-23.

Babat LB, McLain R, Milks R, Ferrara L, Sohn MJ. The ef- fects of the antiresorptive agents calcitonin and pamidronate on spine fusion in a rabbit model. Spine J 2005;5:542-7.

Lee YS, Kim YB, Park SW. Risk factors for postoperative subsidence of single-level anterior cervical discectomy and fusion: the significance of the preoperative cervical align- ment. Spine (Phila Pa 1976) 2014;39:1280-7.

Buerba RA, Giles E, Webb ML, Fu MC, Gvozdyev B, Grauer JN. Increased risk of complications after anterior cervical discectomy and fusion in the elderly: an analysis of 6253 patients in the American College of Surgeons Na- tional Surgical Quality Improvement Program database. Spine (Phila Pa 1976) 2014;39:2062-9.

Chang H, Baek DH, Choi BW. The Relationship between Increased Intervertebral Disc Height and Development of Postoperative Axial Neck Pain after Anterior Cervical Fu- sion. J Korean Neurosurg Soc 2014;55:343-7.

Fu MC, Buerba RA, Grauer JN. Preoperative Nutritional Status as an Adjunct Predictor of Major Postoperative Complications Following Anterior Cervical Discectomy and Fusion. J Spinal Disord Tech 2014. [Epub ahead of print]