Role of Weekly Teriparatide Administration in Osseous Union Enhancement within Six Months After Posterior or Transforaminal Lumbar Interbody Fusion for Osteoporosis-Associated Lumbar Degenerative Disorders

Ebata, Shigeto; Takahashi, J.; Hasegawa, Tomohiko; Mukaiyama, Keijiro; Isogai, Yukihiro; Ohba, Tetsuro; Shibata, Yosuke; Ojima, Toshiyuki; Yamagata, Zentaro; Matsuyama, Yukihiro; Haro, Hirotaka

doi:10.2106/jbjs.16.00230

Cited by 119 publications

(80 citation statements)

References 28 publications

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“…After removing 87 duplications from the 383 references, titles and abstracts of the remaining 296 references were reviewed for eligibility. Then, 12 references from three prospective comparative studies and eight randomized clinical trials were eligible for the comprehensive synthesis ( Fig 1) [ [16][17][18][19][20][21][22][23][24][25][26][27].…”

Section: Resultsmentioning

confidence: 99%

Effects of teriparatide and bisphosphonate on spinal fusion procedure: A systematic review and network meta-analysis

et al. 2020

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Background Giving patients anti-osteoporotic agents peri-operatively is a well-accepted strategy to increase fusion rate and prevent complications. The purpose of this study was to investigate effectiveness of teriparatide and bisphosphonate on fusion surgery of thoracic and lumbar spine. Methods We searched EMBASE and PubMed for randomized clinical trials (RCTs) and prospective comparative studies using teriparatide or bisphosphonate in peri-operative spinal fusion surgery. Our synthesized data of fusion rate, Oswestry disability index (ODI), and adverse event in contrast-based network meta-analysis. Pooled results were presented in risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI). Results Our search hit eight RCTs and three prospective studies with 676 patients receiving spinal surgery. Pooled result showed that teriparatide+Denosumab leads to significantly higher fusion rate than placebo (RR, 2.84; 95% CI: 1.22 to 6.60) and bisphosphonate (RR, 2.59; 95% CI: 1.13 to 5.96). We did not observe significant finding among placebo, teriparatide, and bisphosphonate in the two network models.

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Section: Resultsmentioning

confidence: 99%

Effects of teriparatide and bisphosphonate on spinal fusion procedure: A systematic review and network meta-analysis

et al. 2020

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“…Cho et al [79] compared the effect of PTH1-34 and bisphosphonate administration on posterior lumbar interbody fusion in patients with osteoporosis through a prospective cohort study and concluded that there was no significant improvement in the overall fusion rate at 24 months after surgery and clinical outcome between the two groups, although the PTH1-34 group showed faster bony union than the bisphosphonate group. Ebata et al [80] reported that bone fusion, evaluated on CT images, after posterior or transforaminal lumbar interbody fusion in patients with osteoporosis was significantly higher in patients using PTH1-34 than the no PTH1-34 group, both at 4 and 6 months postoperatively. Although the positive effect of PTH1-34 on bone fusion has been described in both animal models and clinical studies, the specific effect of PTH1-34 for bone fusion after spinal arthrodesis remains to be fully clarified.…”

Section: Pthmentioning

confidence: 99%

The Biological Enhancement of Spinal Fusion for Spinal Degenerative Disease

Makino¹,

Tsukazaki²,

Ukon³

et al. 2018

IJMS

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In this era of aging societies, the number of elderly individuals who undergo spinal arthrodesis for various degenerative diseases is increasing. Poor bone quality and osteogenic ability in older patients, due to osteoporosis, often interfere with achieving bone fusion after spinal arthrodesis. Enhancement of bone fusion requires shifting bone homeostasis toward increased bone formation and reduced resorption. Several biological enhancement strategies of bone formation have been conducted in animal models of spinal arthrodesis and human clinical trials. Pharmacological agents for osteoporosis have also been shown to be effective in enhancing bone fusion. Cytokines, which activate bone formation, such as bone morphogenetic proteins, have already been clinically used to enhance bone fusion for spinal arthrodesis. Recently, stem cells have attracted considerable attention as a cell source of osteoblasts, promising effects in enhancing bone fusion. Drug delivery systems will also need to be further developed to assure the safe delivery of bone-enhancing agents to the site of spinal arthrodesis. Our aim in this review is to appraise the current state of knowledge and evidence regarding bone enhancement strategies for spinal fusion for degenerative spinal disorders, and to identify future directions for biological bone enhancement strategies, including pharmacological, cell and gene therapy approaches.

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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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Role of Weekly Teriparatide Administration in Osseous Union Enhancement within Six Months After Posterior or Transforaminal Lumbar Interbody Fusion for Osteoporosis-Associated Lumbar Degenerative Disorders

Abstract: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Cited by 119 publications

References 28 publications

Effects of teriparatide and bisphosphonate on spinal fusion procedure: A systematic review and network meta-analysis

Effects of teriparatide and bisphosphonate on spinal fusion procedure: A systematic review and network meta-analysis

The Biological Enhancement of Spinal Fusion for Spinal Degenerative Disease

Limitations and complications of minimally invasive spinal surgery in adult deformity

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