Osteoporosis Treatment and Outcomes in Patients Undergoing Adult Spinal DeformitySurgery

<black square> BACKGROUND: This study aims to evaluate the prevalong spinal fusion for adult spinal deformity (ASD) and compare the impact of osteoporosis treatment on surgical and radiographic outcomes. <black square> METHODS: We conducted a retrospective study of adult ASD surgery at a single academic center between 2015 and 2021. We recorded demographic information, procedural details, and pharmacologic treatments. Primary outcomes included preoperative and postoperative sagittal vertical axis, pelvic incidence-lumbar lordosis mismatch, and postoperative complications such as surgical site infecand proximal junctional failure. Patients with osteoporosis were compared to those without. <black square> RESULTS: Among 168 patients, the prevalence of osteoporosis was 28.6%. Osteoporotic patients were older and predominantly female. At the time of surgery, 70.8% of osteoporotic patients were receiving pharmacologic mismatch and sagittal vertical axis did not differ significantly between osteoporotic and nonosteoporotic cohorts. Both cohorts showed similar postoperative improvements. The osteoporotic cohort had a higher rate of PJK (35.4% vs. 17.5%, p[0.01), but no significant difference in proximal junctional failure rates. No significant differences were found between monotherapy and combination therapy outcomes for osteoporotic patients. <black square> CONCLUSIONS: Osteoporotic patients undergoing ASD surgery exhibited similar surgical outcomes and alignment improvements compared to nonosteoporotic patients, despite a higher rate of PJK. Pharmacological treatment appears beneficial in managing osteoporosis-related surgical risks. These findings highlight the importance of identifying and treating osteoporosis in ASD patients to minimize complications.