Evidence for Use of Teriparatide in Spinal Fusion Surgery in Osteoporotic Patients

Chaudhary, Navjot; Lee, Jennifer S.; Wu, Joy Y.; Tharin, Suzanne

doi:10.1016/j.wneu.2016.11.135

Cited by 27 publications

(27 citation statements)

References 31 publications

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“…In this study, we used an 12‐month old OVX rat model 10 month after ovariectomy with more severe osteopenia than that in the established osteopenic animal model 2 month post‐OVX. Clinically, bisphosphonates (BPs) are the first‐line treatment for osteoporosis, while TPTD is approved for failure of BPs, or for severe osteoporosis . Furthermore, it is possible that the 12‐month‐old rat could be a better model of human osteoporosis because the bone remodeling processes could prevail over bone modeling .…”

Section: Discussionmentioning

confidence: 99%

“…Clinically, bisphosphonates (BPs) are the first-line treatment for osteoporosis, while TPTD is approved for failure of BPs, or for severe osteoporosis. [27][28][29] Furthermore, it is possible that the 12-month-old rat could be a better model of human osteoporosis because the bone remodeling processes could prevail over bone modeling. 30 in clinical practices, most osteoporosis patients are aged postmenopausal women, age-related, and OVX induced decrease of BMD contribute simultaneously to the pathogenesis of osteoporosis.…”

Section: Discussionmentioning

confidence: 99%

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Effects of combined teriparatide and zoledronic acid on posterior lumbar vertebral fusion in an aged ovariectomized rat model of osteopenia

Yishake

Yasen

Jiang

et al. 2018

Journal Orthopaedic Research

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There has been no study regarding the effect of a combination of teriparatide (TPTD) and zoledronic acid (ZA) on vertebral fusion. In this study, we investigate the effect of single and combined TPTD and ZA treatment on lumbar vertebral fusion in aged ovariectomized (OVX) rats. Sixty two-month-old female Sprague-Dawley rats were ovariectomized and underwent bilateral L4-L5 posterolateral intertransverse fusion after 10 months. The OVX rats received vehicle (control) treatment, or ZA (100 µg/kg, once), or TPTD (60 µg/kg/2 d for 42 d), or ZA + TPTD until they were euthanized at 6 weeks following lumbar vertebral fusion. The lumbar spine was harvested. Bone mineral density (BMD), bone fusion, bone volume (BV), and bone formation rate (BFR)were analyzed by dual-energy X-ray absorptiometry (DXA), radiography, micro-computed tomography, and histomorphometry. Compared with vehicle (control) treatment, ZA and TPTD monotherapy increased bone volume (BV) at fusion site, and ZA + TPTD combined therapy had an additive effect. Treatment with TPTD and ZA + TPTD increased the bone fusion rate when compared with the control group. ZA monotherapy did not alter the rate of bone fusion. The TPTD and ZA + TPTD treatment groups had increased mineral apposition rate (MAR), mineralizing surfaces/bone surface ((MS/BS), and BFR/BS compared with the OVX group. Our experiment confirm that the monotherapy with TPTD and combination therapy with ZA + TPTD in an OVX rat model of osteopenia following lumbar vertebral fusion surgery increased bone fusion mass and bone fusion rate, and ZA + TPTD combined therapy had an additive effect on bone fusion mass. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:937-944, 2018.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Effects of combined teriparatide and zoledronic acid on posterior lumbar vertebral fusion in an aged ovariectomized rat model of osteopenia

Yishake

Yasen

Jiang

et al. 2018

Journal Orthopaedic Research

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“…They also noted that collagen denaturation similar to coagulative changes accompanying other insect bites are sometimes present along with vasodilation, acute thrombophlebitis, and arteritis. Chaudhary et al 2 reported that in biopsies of the eschar areas, keratinocyte necrosis, basal vacuolar degeneration, and red blood cell (RBC) entrapment were observed in the epidermis in approximately 20% of cases. In the dermis, leukocytoclastic vasculitis, neutrophil infiltration, and RBC extravasation were observed in 93.3%, 86.7%, and 93.3% of cases, respectively, but lymphocytic vasculitis was observed only in 6.7% of the cases.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies have investigated the histopathologic findings of eschars characterized by a hard black crust on the skin surface in tsutsugamushi disease. Leukocytoclastic vasculitis and neutrophil infiltration were reported to be major findings in eschar lesions 2 . However, these findings may result from secondary changes following tissue necrosis.…”

Section: Introductionmentioning

confidence: 99%

Histopathologic Finding of Perieschar Lesions in Tsutsugamushi Disease Shows Lymphocytic Vasculitis Mimicking Angiocentric Lymphoma

et al. 2018

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BackgroundTsutsugamushi disease is an acute, febrile, infectious disease caused by Orientia tsutsugamushi. Several studies investigating the histopathologic findings of eschars in tsutsugamushi disease reported leukocytoclastic vasculitis and neutrophil infiltration as the major findings. However, these findings may result from secondary changes following tissue necrosis. The histopathologic findings of perieschar lesions may be important to understand the primary changes associated with tsutsugamushi disease.ObjectiveTo investigate characteristic histopathologic features of perieschar lesions and suppose the mechanism of vascular pathophysiological changes associated with tsutsugamushi disease.MethodsWe analyzed histopathological slides of perieschar lesions in 12 patients diagnosed with tsutsugamushi disease.ResultsIn the epidermis, exocytosis of mononuclear cells (75.0%) and basal vacuolar changes (66.7%) were frequent. In the dermis, perivascular, interstitial, and perineural mononuclear cell infiltration (100.0%, 83.3%, and 83.3%, respectively), as well as thrombosis (83.3%), atypical lymphocyte infiltration (91.7%), and mitotic figures (83.3%) were commonly seen. Lymphocytic vasculitis and mononuclear cell infiltration around eccrine glands were found in all cases, but eosinophil infiltration was only found in one patient (8.3%). However, the characteristic findings of eschar lesions, such as leukocytoclastic vasculitis and neutrophil infiltration, were not found in perieschar lesions.ConclusionThe major histopathologic findings in the perieschar lesions of tsutsugamushi disease were lymphocytic vasculitis and atypical lymphocytic infiltration, mimicking lymphoma. Therefore, we suggest that this lesion should be added to the list of pseudolymphomas. To observe these characteristic histopathologic features, we also recommend that skin biopsies should be performed on perieschar lesions, not eschar lesions.

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“…Perioperative treatment with recombinant human parathyroid hormone (teriparatide/Forteo) has been useful for preoperative augmentation of bone quality, with good outcomes in patients with poor bone mineral density scores. This drug not only has antiresorptive but also osteoinductive properties that quickly re-establish good bone quality in patients requiring major spinal deformity surgery (7)(8)(9)(10)(11)(12).…”

Section: Patient Selectionmentioning

confidence: 99%

Limitations and complications of minimally invasive spinal surgery in adult deformity

Januszewski¹,

Vivas²,

Uribe³

2018

Ann. Transl. Med.

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Minimally invasive spine (MIS) surgery has rapidly progressed from simple short segment fusions to large adult deformity corrections, with radiographic and clinical outcomes as good as those of open surgery. Anterior longitudinal ligament release (ALLR) and anterior column realignment (ACR) have been key advancements in the ability to correct deformity using MIS techniques. However, patient selection and appropriate preoperative workup is critical to obtain good outcomes and for complication avoidance. Despite favorable outcomes in spinal deformity surgery, MIS techniques are limited in (I) pronounced cervical or thoracic deformity; (II) patients with prior fusion mass; and (III) severe sagittal imbalance necessitating Schwab 5 osteotomy or higher. Guidelines for proper patient selection are needed to guide MIS spine surgeons in choosing the right candidate.

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Evidence for Use of Teriparatide in Spinal Fusion Surgery in Osteoporotic Patients

Cited by 27 publications

References 31 publications

Effects of combined teriparatide and zoledronic acid on posterior lumbar vertebral fusion in an aged ovariectomized rat model of osteopenia

Effects of combined teriparatide and zoledronic acid on posterior lumbar vertebral fusion in an aged ovariectomized rat model of osteopenia

Histopathologic Finding of Perieschar Lesions in Tsutsugamushi Disease Shows Lymphocytic Vasculitis Mimicking Angiocentric Lymphoma

Limitations and complications of minimally invasive spinal surgery in adult deformity

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