ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023
Do peri-operative parathyroid hormone (PTH) analogues improve bone density and decrease mechanical complications in spinal deformity correction?-a minimum 2-year radiological study measuring Hounsfield units.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 5 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- A bone optimization rheumatology clinic increases anabolic bone agent use and reduces mechanical complications in adult spinal deformity surgery.Spine deformity · 2026Article
- Diagnostic Value of Opportunistic CT-Based Bone Density Assessment in Patients with and Without Sacral Insufficiency Fractures.Diagnostics (Basel, Switzerland) · 2025Article
- Opportunistic Osteoporosis Assessment and Fracture Risk Determination Using Cancellous Density Measurement in Hounsfield Units of Native Lumbar Computed Tomography Images-A Comparative Study with Conventional Bone Density Evaluation.Journal of clinical medicine · 2025Article
- [Comparative evaluation of trabecular bone density in Hounsfield units in the lumbar native CT cross-section for osteoporosis diagnosis and fracture risk determination by different examiners].Orthopadie (Heidelberg, Germany) · 2025Article
- Bone Health Optimization in Adult Spinal Deformity Patients: A Narrative Review.Journal of clinical medicine · 2024Review
Corrections and comments
- Erratum issued
Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo delineate whether use of a PTH analogue in the 1-year peri-operative period improves lumbar bone density.
methodsA prospectively collected data registry of 254 patients who underwent CMIS correction of ASD (Cobb angle > 20 or SVA > 50 mm or (PI-LL) > 10) from Jan 2011 to Jan 2020 was analysed. Patients who were placed on PTH analogues for one year in conjunction with surgery were included in the study. Ultimately, 41 patients who had pre- and two-year post-operative CT scans for review were included in this study. Hounsfield units were measured off of the L1-L3 levels for all patients before and after surgery on pre-op and post-op CT scans.
resultThe mean age of patients in this study was 70 (52-84, SD 7). Mean follow-up was 66 (24-132, SD 33) months. Twenty-three patients met criteria for severe deformity (Cobb angle > 50 degrees or SVA > 95 mm or PI/LL mismatch > 20 or PT > 30). Based off 2-year post-op CT scan, there were significant improvements in L1 Hounsfield units when comparing pre-op values (96; SD 55) to post-op values (185 SD 102); p. < 0.05. There was no screw loosening or screw pull out. There were 2 patients with PJF (4.8%). Both these patients had not completed their PTH treatment: one only took PTH for 3 months (PJF at 2-year post-op) and the other one took it only for 1 month (PJF at 1-year post-op). No increase in bone density was noted (based off of Hounsfield units) in five patients (12%) despite completion of their PTH therapy. Only one patient experienced nausea from PTH therapy. There were no other PTH related adverse events.
conclusionThe incidence of PTH analogues failing to increase bone density in our series was low at 12%. This study shows that PTH analogues may be a powerful adjunct for increasing bone density and may help to mitigate the risk of mechanical complications in patients undergoing deformity correction with minimally invasive techniques. Future comparative studies are warranted to confirm these latter findings and to potentially protocolize the ideal peri-operative bone health optimization strategy.
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