Osteoporosis and the Management of Spinal Degenerative Disease

Document Type: CURRENT CONCEPTS REVIEW

Authors

Spine Department. Fundacion Jimenez Diaz University Hospital, Madrid. Spain

Abstract

Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosis
predisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concern
before performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often been
considered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequate
procedures in order to avoid concomitant instrumentation. As the population ages and the expectations of older patients
increase, the demand for surgical treatment in older patients with osteoporosis and spinal degenerative diseases
becomes progressively more important. Nowadays, advances in surgical and anesthetic technology make it possible to
operate successfully on elderly patients who no longer accept disabling physical conditions. This article discusses the
biomechanics of the osteoporotic spine, the diagnosis and management of osteoporotic patients with spinal conditions,
as well as the novel treatments, recommendations, surgical indications, strategies and instrumentation in patients with
osteoporosis who need spine operations.

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