Chin D K, Park J Y, Yoon Y S, Kuh S U, Jin B H, Kim K S, Cho Y E
Department of Neurosurgery,Yongdong Severance Spine Hospital, Yonsei University College of Medicine, 146-92, Dogok-dong, Kangnam-gu, Seoul, 135-720, South Korea.
Osteoporos Int. 2007 Sep;18(9):1219-24. doi: 10.1007/s00198-007-0370-8. Epub 2007 Mar 27.
The purpose of this study is to evaluate the incidence of osteoporosis in patients requiring spine surgery. Among patients older than 50 years, the rate of osteoporosis in males was 14.5% and the rate osteoporosis in females was 51.3%. We strongly recommend an evaluation and treatment for osteoporosis in the patients requiring spine surgery, especially in females over 50 years old.
Because lifespan is increasing, there is an increase in the incidence of osteoporosis in elderly spine surgery patients. The osteoporosis may adversely influence the fusion rate and the surgical outcome. The purpose of this study is to evaluate the incidence of osteoporosis in patients requiring spine surgery.
A total of 1,321 patients underwent spine surgeries at our institute from January 1, 2005 to December 31, 2005. Among them, there were 562 patients (42.5%) younger than 50 years old, and 759 patients (57.6%) older than 50 years old. Prior to operation, we evaluated the patients for osteoporosis on both the femur head and lumbar spine by measuring the bone mineral density (BMD) by the dual-energy X-ray absorptiometry (DXA). Based on the World Health Organization (WHO) criteria for osteoporosis, we chose the T-score to determine normal (>-1), osteopenia (-1>or=, >-2.5), and osteoporosis (<or=-2.5). Among the 562 patients younger than 50 years, DXA was performed in 22 (3.9%) patients and there were 13 (2.3%) cases of osteopenia and 2 (0.3%) cases of osteoporosis.
Among 759 patients older than 50 years, DXA was performed on 516 (68.0%) patients, 193 males and 323 females. Among the male patients, there were 89 (46.1%) patients with osteopenia and 28 (14.5%) with osteoporosis. Among the female patients, there were 134 (41.4%) with osteopenia and 166 (51.3%) with osteoporosis. The incidence of osteoporosis was higher in female patients and significantly increased with increasing age. Among 759 patients older than 50 years, 676 patients underwent a major spine operation with or without fusion. Among these patients, DXA was performed in 446 (66.0%) patients and there were 207 (46.4%) patients with osteopenia and 139 (31.1%) with osteoporosis.
The patients over 50 year-old who need spine operation have osteoporosis often. In conclusion, the number of spine operations in elderly patients is increasing and the incidence of osteoporosis in spine surgery patients is also increasing. We strongly recommend an evaluation for osteoporosis and post-operative treatment for osteoporosis in patients over 50 years old, especially for female patients.
本研究的目的是评估需要进行脊柱手术的患者中骨质疏松症的发病率。在50岁以上的患者中，男性骨质疏松症的发生率为14.5%，女性为51.3%。我们强烈建议对需要进行脊柱手术的患者，尤其是50岁以上的女性患者，进行骨质疏松症的评估和治疗。
由于寿命延长，老年脊柱手术患者中骨质疏松症的发病率有所上升。骨质疏松症可能会对融合率和手术效果产生不利影响。本研究的目的是评估需要进行脊柱手术的患者中骨质疏松症的发病率。
2005年1月1日至2005年12月31日期间，共有1321例患者在我院接受了脊柱手术。其中，562例（42.5%）患者年龄小于50岁，759例（57.6%）患者年龄大于50岁。术前，我们通过双能X线吸收法（DXA）测量股骨头和腰椎的骨密度（BMD），对患者进行骨质疏松症评估。根据世界卫生组织（WHO）的骨质疏松症标准，我们选择T值来确定正常（>-1）、骨量减少（-1≥，>-2.5）和骨质疏松症（≤-2.5）。在562例年龄小于50岁的患者中，22例（3.9%）患者进行了DXA检查，其中13例（2.3%）为骨量减少，2例（0.3%）为骨质疏松症。
在759例年龄大于50岁的患者中，516例（68.0%）患者进行了DXA检查，其中男性193例，女性323例。在男性患者中，89例（46.1%）为骨量减少，28例（14.5%）为骨质疏松症。在女性患者中，134例（41.4%）为骨量减少，166例（51.3%）为骨质疏松症。女性患者中骨质疏松症的发生率更高，且随着年龄的增加显著上升。在759例年龄大于50岁的患者中，676例患者接受了有或无融合的大型脊柱手术。在这些患者中，446例（66.0%）患者进行了DXA检查，其中207例（46.4%）为骨量减少，139例（31.1%）为骨质疏松症。
50岁以上需要进行脊柱手术的患者常患有骨质疏松症。总之，老年患者脊柱手术的数量在增加，脊柱手术患者中骨质疏松症的发病率也在上升。我们强烈建议对50岁以上的患者，尤其是女性患者，进行骨质疏松症评估和术后治疗。
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