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Osteoporotic profiles in elderly patients with symptomatic lumbar spinal canal stenosis.

Lee BH, Moon SH, Kim HJ, Lee HM, Kim TH - Indian J Orthop (2012)

Bottom Line: Statistical analysis used were multivariate logistic regression with a forward stepwise procedure.Fifty-nine patients (55.6%) had hypovitaminosis D.All bone turnover makers [alkaline phosphatase, osteocalcin, urinary-N-terminal telopeptide (u-NTx)] were demonstrated to be within normal range.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: The osteoporosis and lumbar canal stenosis, in elderly patients are under diagnosed and under reported. We report a cross sectional study to demonstrate the osteoporotic profile in patients with lumbar spinal stenosis (LSS) and to determine the proportion of patients with LSS who need to be treated for osteoporosis.

Materials and methods: One hundred and six postmenopausal patients with symptomatic LSS were evaluated for osteoporotic profile, which included lumbar and hip bone mineral density (BMD), serum vitamin D concentration, bone resorption and formation markers. Demographic and disease related variables were analyzed to identify the association with the risk of osteoporosis or osteopenia. Statistical analysis used were multivariate logistic regression with a forward stepwise procedure.

Results: Twenty-four patients (22.6%) had osteoporosis and 60 (56.6%) had osteopenia. Overall, 84 patients (79.2%) with symptomatic LSS had osteoporosis or osteopenia. Fifty-nine patients (55.6%) had hypovitaminosis D. All bone turnover makers [alkaline phosphatase, osteocalcin, urinary-N-terminal telopeptide (u-NTx)] were demonstrated to be within normal range. Only age was associated with the risk of osteoporosis or osteopenia in the hip region. In the lumbar spine, all variables were not associated with osteoporosis or osteopenia. 44 patients (41.5%) required treatment for osteoporosis as per risk factors for osteoporosis. According to the guidelines from the Health Insurance Review Agency, however, only 20 patients (18.8% required) qualified for reimbursement for osteoporosis medications.

Conclusions: LSS is associated with osteopenia, osteoporosis, and hypovitaminosis D, which should prompt careful screening and treatment in cases of osteoporosis and osteoarthritis.

No MeSH data available.


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Mentions: All patients were scheduled to be treated with lumbar spinal decompression and/or posterior spinal fusion. Patients’ demographic characteristics were obtained and each completed a questionnaire assessing for osteoporotic risk factors [Appendix 1].12 Preoperative imaging studies included plain radiographs of the lumbar and thoracic spine, including dynamogram of designated level and both knee joints. MRI of the lumbosacral spine was performed to confirm LSS and subsequently plan lumbar spinal surgery was done. For the assessment of functional disability due to spinal stenosis, the Oswestry Disability Index (ODI) was recorded before the surgical treatment. Osteoporotic profiles included measurement of lumbar and hip bone mineral density (BMD) (Hologic, Waltham, MA, USA), serum vitamin D concentration, urinary-N-terminal telopeptide (u-NTx) as a bone resorption marker, and serum osteocalcin and serum alkaline phosphatase as bone formation markers.


Osteoporotic profiles in elderly patients with symptomatic lumbar spinal canal stenosis.

Lee BH, Moon SH, Kim HJ, Lee HM, Kim TH - Indian J Orthop (2012)

© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3377137&req=5

Mentions: All patients were scheduled to be treated with lumbar spinal decompression and/or posterior spinal fusion. Patients’ demographic characteristics were obtained and each completed a questionnaire assessing for osteoporotic risk factors [Appendix 1].12 Preoperative imaging studies included plain radiographs of the lumbar and thoracic spine, including dynamogram of designated level and both knee joints. MRI of the lumbosacral spine was performed to confirm LSS and subsequently plan lumbar spinal surgery was done. For the assessment of functional disability due to spinal stenosis, the Oswestry Disability Index (ODI) was recorded before the surgical treatment. Osteoporotic profiles included measurement of lumbar and hip bone mineral density (BMD) (Hologic, Waltham, MA, USA), serum vitamin D concentration, urinary-N-terminal telopeptide (u-NTx) as a bone resorption marker, and serum osteocalcin and serum alkaline phosphatase as bone formation markers.

Bottom Line: Statistical analysis used were multivariate logistic regression with a forward stepwise procedure.Fifty-nine patients (55.6%) had hypovitaminosis D.All bone turnover makers [alkaline phosphatase, osteocalcin, urinary-N-terminal telopeptide (u-NTx)] were demonstrated to be within normal range.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul, Korea.

ABSTRACT

Background: The osteoporosis and lumbar canal stenosis, in elderly patients are under diagnosed and under reported. We report a cross sectional study to demonstrate the osteoporotic profile in patients with lumbar spinal stenosis (LSS) and to determine the proportion of patients with LSS who need to be treated for osteoporosis.

Materials and methods: One hundred and six postmenopausal patients with symptomatic LSS were evaluated for osteoporotic profile, which included lumbar and hip bone mineral density (BMD), serum vitamin D concentration, bone resorption and formation markers. Demographic and disease related variables were analyzed to identify the association with the risk of osteoporosis or osteopenia. Statistical analysis used were multivariate logistic regression with a forward stepwise procedure.

Results: Twenty-four patients (22.6%) had osteoporosis and 60 (56.6%) had osteopenia. Overall, 84 patients (79.2%) with symptomatic LSS had osteoporosis or osteopenia. Fifty-nine patients (55.6%) had hypovitaminosis D. All bone turnover makers [alkaline phosphatase, osteocalcin, urinary-N-terminal telopeptide (u-NTx)] were demonstrated to be within normal range. Only age was associated with the risk of osteoporosis or osteopenia in the hip region. In the lumbar spine, all variables were not associated with osteoporosis or osteopenia. 44 patients (41.5%) required treatment for osteoporosis as per risk factors for osteoporosis. According to the guidelines from the Health Insurance Review Agency, however, only 20 patients (18.8% required) qualified for reimbursement for osteoporosis medications.

Conclusions: LSS is associated with osteopenia, osteoporosis, and hypovitaminosis D, which should prompt careful screening and treatment in cases of osteoporosis and osteoarthritis.

No MeSH data available.


Related in: MedlinePlus