RICARDO CEPEDA JORDAN, PEDRO LUIS BAZáN, JOSé CARLOS SORIA ADARO
{"title":"USE OF TERIPARATIDE IN SURGICAL PLANNING FOR PATIENTS WITH OSTEOPOROSIS","authors":"RICARDO CEPEDA JORDAN, PEDRO LUIS BAZáN, JOSé CARLOS SORIA ADARO","doi":"10.1590/s1808-185120222203270489","DOIUrl":null,"url":null,"abstract":"ABSTRACT Currently, there are no guidelines for treating osteoporosis in spinal surgery. The rate of complications such as screw loosening, proximal junction kyphosis, cage subsidence, and loss of reduction in fractures is high. Objective: To evaluate the use of teriparatide and denosumab in planning spinal surgery in an osteoporotic patient with degenerative pathology, emphasizing the fusion rate, bone mineral density, and decreased complications. Method: A systematic search was performed in medical reference databases for comparative studies of teriparatide and denosumab in spinal surgery to evaluate fusion, screw loosening, bone mineral density, and decrease in the incidence of vertebral fractures. χ2 was implemented for the statistical analysis, according to PRISMA (2020). Result: Fusion rate with teriparatide was 79.28% in the first six months, 95% CI (OR 2.62) and decreased screw loosening rate 81.9% 95% CI (OR 0.6). Increase in bone mineral density 15.5% OR 1.49 (0.77 - 2.86) and decrease in vertebral fracture rate 85.4% OR 0.5. Conclusions: Teriparatide and denosumab should be considered in perioperative spinal planning due to their effectiveness, synergism, and low adverse effects; to improve bone mineral density and decrease the rate of complications. Clinical, comparative, and statistically significant studies are required to confirm this. Level of Evidence II; Systematic Review and Meta-analysis.","PeriodicalId":40025,"journal":{"name":"Coluna/ Columna","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Coluna/ Columna","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1590/s1808-185120222203270489","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
ABSTRACT Currently, there are no guidelines for treating osteoporosis in spinal surgery. The rate of complications such as screw loosening, proximal junction kyphosis, cage subsidence, and loss of reduction in fractures is high. Objective: To evaluate the use of teriparatide and denosumab in planning spinal surgery in an osteoporotic patient with degenerative pathology, emphasizing the fusion rate, bone mineral density, and decreased complications. Method: A systematic search was performed in medical reference databases for comparative studies of teriparatide and denosumab in spinal surgery to evaluate fusion, screw loosening, bone mineral density, and decrease in the incidence of vertebral fractures. χ2 was implemented for the statistical analysis, according to PRISMA (2020). Result: Fusion rate with teriparatide was 79.28% in the first six months, 95% CI (OR 2.62) and decreased screw loosening rate 81.9% 95% CI (OR 0.6). Increase in bone mineral density 15.5% OR 1.49 (0.77 - 2.86) and decrease in vertebral fracture rate 85.4% OR 0.5. Conclusions: Teriparatide and denosumab should be considered in perioperative spinal planning due to their effectiveness, synergism, and low adverse effects; to improve bone mineral density and decrease the rate of complications. Clinical, comparative, and statistically significant studies are required to confirm this. Level of Evidence II; Systematic Review and Meta-analysis.
目前,脊柱手术中治疗骨质疏松尚无指南。并发症的发生率很高,如螺钉松动、近端关节后凸、固定架下沉和骨折复位丧失。目的:评价特立帕肽和地诺单抗在骨质疏松伴退行性病理患者脊柱手术计划中的应用,强调融合率、骨密度和并发症的减少。方法:系统检索医学参考数据库,比较特立帕肽和地诺单抗在脊柱外科手术中的应用,评价融合、螺钉松动、骨密度和椎体骨折发生率的降低。χ2进行统计分析,参照PRISMA(2020)。结果:前6个月特立帕肽的融合率为79.28%,95% CI (OR 2.62),螺钉松动率降低81.9%,95% CI (OR 0.6)。骨密度升高15.5%或1.49(0.77 - 2.86),椎体骨折率降低85.4%或0.5。结论:特立帕肽和地诺单抗因其有效性、协同性和低不良反应,在围手术期脊柱规划中应考虑;提高骨密度,降低并发症发生率。需要临床、比较和统计上有意义的研究来证实这一点。证据水平II;系统评价和荟萃分析。