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Title: Prevalence of Poor Bone Quality in Patients Undergoing Spine Surgery: A Comprehensive Approach
Authors: Díaz-Romero Paz, Ricardo Fernando 
Sosa Henríquez, Manuel José 
Melián, Kevin Armas
Martin, Claudia Balhen
UNESCO Clasification: 32 Ciencias médicas
320714 Osteopatología
321304 Cirugía de huesos
Keywords: Bone Mineral Density
Fracture Risk Assessment Tool
Spine Surgery, et al
Issue Date: 2021
Journal: Global Spine Journal 
Abstract: Study Design: A cross-sectional study. Objectives: To investigate the prevalence of poor bone quality in patients requiring spine surgery through comprehensive evaluation with bone mass density (BMD), trabecular bone score (TBS), FRAX, and vitamin D status. Methods: we prospectively recruited patients of > 50 years old candidates for lumbar or cervical spine fusion surgery at our institution. Recorded data were: demographic, body mass index (BMI), risk factors for osteoporosis, daily calcium intake, FRAX score, disability index for lumbar and cervical spine, and VAS for pain. Serum 25 OH vitamin D, BMD using DXA, and TBS was also evaluated. Results: A total of 104 patients were recruited, osteoporosis by BMD was detected in 9.6%, and osteopenia in 34.6% of patients. 69.4% of patients with osteopenia had a degraded or partially degraded bone microarchitecture by TBS. Low levels of vitamin D were detected in 79.8% of patients. Increased pain was associated with low BMD levels. Adding TBS to BMD for the determination of bone strength resulted in 33.7% of patients with poor bone quality. Lastly, the combination of BMD, TBS, and FRAX revealed 37,5% of patients with poor bone quality. Conclusions: Poor bone quality and low vitamin D levels are quite common among patients aged ≥ 50 years undergoing spine surgery. DXA alone seems not enough for preoperative identification of impaired bone quality cases. FRAX is useful for identifying high-risk patients and TBS is a valuable complement to DXA by adding the dimension of bone quality.
ISSN: 2192-5682
DOI: 10.1177/2192568221989684
Source: Global Spine Journal [ISSN 2192-5682], (Enero 2021)
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