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. 2021 Apr;15(2):376-385.
doi: 10.14444/8049. Epub 2021 Mar 11.

Practice Patterns of Spine Surgeons Regarding Osteoporosis: An International Survey

Ricardo Díaz-Romero  1   2 , Manuel Sosa Henríquez  1   3 , Kevin Armas Melián  2 , Claudia Balhen-Martin  4
Affiliations

Practice Patterns of Spine Surgeons Regarding Osteoporosis: An International Survey

Ricardo Díaz-Romero et al. Int J Spine Surg. 2021 Apr.

Abstract

Background: Osteoporosis (OP) represents a great challenge for the spine surgeon. Despite having effective pharmacological treatments for OP and surgical technical innovations, the awareness of spine surgeons regarding OP seems low. The purpose of this research was to assess practice patterns on the diagnosis and treatment of spine surgeons regarding OP.

Methods: An electronic survey of ten multiple-choice questions was administered to members of the European Association of Neurosurgical Societies (EANS). The survey asked about the specialty, the workplace, and practice patterns and attitudes regarding OP and spine fusion surgery, pseudoarthrosis, and vertebral compression fractures (VCF).

Results: A total of 122 surgeons completed the survey. In patients with suspected OP, 31.4% of surgeons would refer the patient to the OP specialist before surgery and 21.5% chose to perform the surgery without additional studies. A 66.4% of respondents would modify the surgical strategy in the case of OP. The most popular surgical techniques elected were cemented augmented screws (77.9%) and long-segment instrumentation (45.1%). Regarding pseudoarthrosis, 29.5% of surgeons opted to refer to the OP specialist, and 23.8% didn't consider any additional studies Concerning VCF management, 41.32% of respondents would refer the patient for treatment of OP, and the most common therapeutic strategy was conservatively treatment for 4 to 6 weeks and vertebroplasty or kyphoplasty if no improvement (55.74%).There was a higher proportion of surgeons that would not consider preoperative studies or referring patients with suspected OP for spine surgery (χ2 = 4.48, P = .03) and pseudoarthrosis (χ2 = 9.5, P = .002) compared to VCF.

Conclusions: There was a greater awareness regarding optimizing OP management in VCF compared to patients with suspected OP for spine arthrodesis or pseudoarthrosis. There still opportunities for improvement for the timely diagnosis and treatment of OP in spine surgery patients.

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Conflict of interest statement

Disclosures and COI: The authors received no funding for this study and report no conflicts of interest.

Figures

Figure 1
Figure 1
Participants in the survey who were members of European Association of Neurosurgical Societies (EANS), by countries.
Figure 2
Figure 2
Comparative analysis on trends between suspected osteoporosis (OP), pseudoarthrosis and vertebral compression fracture (VCF). *P < .05. NS, nonsignificant statistically.
See this image and copyright information in PMC

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