TY - JOUR
TI - The Role of Bone Mineral Density in a Successful Lumbar Interbody Fusion: A Narrative Review
AU - Kyriakos Bekas
AU - Christos Zafeiris
JO - CUREUS
PY - 2024
VL - 16
TODO - 2
SP - 1-9
PB - Springer Science and Business Media LLC
SN - null
TODO - 10.7759/cureus.54727
TODO - mineral bone metabolism, osteoporosis treatment, lumbar interbody fusion, s: osteoporosis, cage subsidence, bone mineral density
TODO - Background: The incidence of osteoporosis is a prime concern, especially in parts of the world where the
population is aging, such as Europe or the US. Many new therapy strategies have been described to enhance
bone healing. Lumbar interbody fusion (LIF) is a surgical procedure that aims to stabilize the lumbar spine
by fusing two or more vertebrae using an interbody cage. LIF is a standard treatment for various spinal
conditions, such as degenerative disc disease, spinal stenosis, and spondylolisthesis. However, successful
fusion is challenging for patients with osteoporosis due to their reduced bone mineral density (BMD) and
increased risk of cage subsidence, which can lead to implant failure and poor clinical outcomes.
Methods: A comprehensive literature search yielded 220 articles, with 16 ultimately included. Keywords
included BMD, cage subsidence, osteoporosis, teriparatide, and lumbar interbody fusion.
Results: This review examines the relationship between BMD and LIF success, emphasizing the importance
of adequate bone quality for successful fusion. Preoperative assessment methods for BMD and the impact of
low BMD on fusion rates and patient outcomes are discussed. Additionally, techniques to improve fusion
success in patients with weakened bone density, such as biological enhancement and BMD-matched
interbody cages, are explored. However, consensus on the exact BMD threshold for a successful outcome
remains elusive.
Conclusion: While an apparent correlation between BMD and fusion rate in LIF procedures is acknowledged,
conclusive evidence regarding the precise BMD threshold indicative of an increased risk of unfavorable
outcomes remains elusive. Surgeons are advised to exercise caution in surgical planning and follow-up for
patients with lower BMD. Furthermore, future research initiatives, particularly longitudinal studies, are
encouraged
ER -