gms | German Medical Science

73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

Influence of sarcopenia and bone mineral densitiy on implant failure after spinal instrumentation in patients with osteoporotic vertebral fractures

Einfluss von spinaler Muskelmasse, Knochendichte und Frailty auf den Erfolg einer dorsalen Spondylodese bei osteoporotischen Wirbelkörperfrakturen

Meeting Abstract

  • presenting/speaker Leon Schmidt - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
  • Dragan Jankovic - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
  • Florian Ringel - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
  • Harald Krenzlin - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland
  • Naureen Keric - Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Neurochirurgische Klinik und Poliklinik, Mainz, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV099

doi: 10.3205/22dgnc101, urn:nbn:de:0183-22dgnc1019

Published: May 25, 2022

© 2022 Schmidt et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: Osteoporosis is the most common age-related progressive skeletal disease characterized by bone loss and a predisposition for osteoporotic vertebral fractures. The management often necessitates fusion surgery, with high rates of implant failure. We aim to determine the impact of frailty, sarcopenia, and bone density on the complication rate and implant failure in patients with lumbar spondylodesis due to osteoporotic vertebral fractures.

Methods: Data acquisition was conducted as a single-center retrospective analysis. Patients diagnosed with osteoporotic fractures between 2011 and 2020, were included in our study. To determine sarcopenia, cross-sectional areas of the psoas at L3 and L4 were measured using axial CT images. Bone density (HU) of the vertebral body was measured at the same levels. Charlson Comorbidity Index (CCI) and Groning frailty index (GFI) were used to assess frailty of each patient. Primary end point were early surgical complications, implant loosening and persistent lower back pain during follow-up examinations.

Results: 79 Patients underwent instrumentation for osteoporotic vertebral fractures in 202 segments (median age 73.9±8.7 years, 41.8% female). Median time of follow up was 9.5 months (IQR 21.25 mo). Median CCI in our cohort was 4 (IQR of 2), median GFI was 4 (IQR of 2). Early surgical complications occurred in 11 patients (13.9%, mean age 71.3±7.3 years, median CCI 4, median GFI 4) implant loosening in 16 patients (20.2%, mean age 73.99±7.8 years, median CCI 4, median GFI 4). No difference was found between CCI and GFI both groups. The z normalised spinal muscle area negatively correlated with component loosening (R=-0.2829 p=0.015). Bone densitiy and CCI showed no statisticaly significant diffenence. At the time of the follow up 77.8% of patients reported having lower back pain (median NRS 2.5 IQR 4).

Conclusion: In our cohort, sarcopenia was associated with implant failure in patients with osteoporotic vertebral fractures, while age and frailty had no influence. Thus, spinal muscle mass serves as predictor and might offer insights into the prevention of impending implant failure.