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Assessing Bone Health for Spinal Fusion: Novel Technique

By Admin | March 28, 2021

A patient’s bone health can mean the difference between regaining mobility and quality of life after spinal fusion and continuing to deal with pain or disability. That means detecting skeletal abnormalities prior to surgery is crucial, but a 2021 study in the journal Bone suggests the most widely used technology for the task may not be ideal. 

Researchers from the Hospital for Special Surgery (HSS) in New York City looked at 54 men and women scheduled for spinal fusion at HSS between December 2017 and December 2019. Patients underwent conventional scans with dual x-ray absorptiometry (DXA) as well as scans with a technique called high-resolution quantitative computed tomography, usually abbreviated to HR-pQCT or Xtreme CT.

The hypothesis was that a more sensitive measure of bone quality through Xtreme CT might identify skeletal abnormalities that DXA would not pick up, and these readings would correlate with postoperative complications. 

That turned out to be correct. Of the 54 patients, 14 of them experienced problems within six months after surgery, including: 

  • Fractures
  • Loosened bone screws
  •  Broken rods
  • Abnormal bending in the spine

These patients were much more likely to have abnormalities in their initial Xtreme CT scans that weren’t evident with DXA imaging, according to study lead Emily Stein, MD, an HSS endocrinologist and bone specialist.

“The problem here is that a DXA scan may not be giving spinal surgeons all the information they need about potential abnormalities and deficits in their patients’ bones,” she says. “What appears normal on the scan may, in fact, turn out to be weak bone during surgery.”

Need for Strong Fusion Outcomes

Spinal fusion is one of the most commonly performed orthopedic surgeries in the United States, and the recent...(More)

For more information please read, Assessing Bone Health for Spinal Fusion: Novel Technique, by spineuniverse 

 

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