• Shoji Seki, Norikazu Hirano, Yoshiharu Kawaguchi, Masato Nakano, Taketoshi Yasuda, Kayo Suzuki, Kenta Watanabe, Hiroto Makino, Masahiko Kanamori, and Tomoatsu Kimura.
• Department of Orthopaedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan. seki@med.u-toyama.ac.jp.
• Eur Spine J. 2017 Aug 1; 26 (8): 2121-2127.

PurposeComplications of adult spinal deformity surgery are problematic in osteoporotic individuals. We compared outcomes between Japanese patients treated perioperatively with teriparatide vs. low-dose bisphosphonates.MethodsFifty-eight osteoporotic adult Japanese female patients were enrolled and assigned to perioperative teriparatide (33 patients) and bisphosphonate (25 patients) groups in non-blinded fashion. Pre- and post-operative X-ray and computed tomography imaging were used to assess outcome, and rates were compared between the groups and according to age. Pain scores and Oswestry Disability Indices (ODI) were calculated before and 2 years after surgery.ResultsAdjacent vertebral fractures and implant failure, fusion failure, and poor pain and ODI outcomes were significantly more common in the bisphosphonates group than the teriparatide group.ConclusionsPerioperative administration of teriparatide is more effective than that of low-dose bisphosphonates in preventing complications and maintaining fusion rates in osteoporotic Japanese females with spinal deformities undergoing surgery.

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