Undiagnosed Osteoporosis in Spine Fusion Surgery

Study: CT Scan Prior to Spine Fusion Surgery Finds Significant Number of Patients Had Undiagnosed Osteoporosis – Mar 2019

For patients contemplating spinal fusion surgery to alleviate pain, bone health is an important consideration.

If a patient is found to have low bone density prior to surgery, it could affect the treatment plan before, during and after the procedure. A study at Hospital for Special Surgery (HSS) in New York City found that a CT scan of the lumbar spine prior to surgery indicated that a significant number of patients had low bone density that was previously undiagnosed.

And I assume they then had the surgery in spite of it. 

Once the “medical machine” for a surgical procedure is started, it involves close to a dozen individuals and time slots, and the patient’s progress within the hospital is so carefully orchestrated and choreographed that it might be simpler to just go ahead as planned.

Almost half of the nearly 300 patients tested were diagnosed with osteoporosis or its precursor, osteopenia for the first time.

Spinal fusion is a very common surgery, with 400,000 to 500,000 such procedures performed in the United States each year. Two-thirds are fusions in the lumbar, or lower, spine. 

“The purpose was to measure lumbar spine bone density using QCT and determine the prevalence of osteopenia or osteoporosis in patients undergoing lumbar spine fusions. We believe that QCT is more effective in screening patients   because the DXA scan can overestimate bone density in the spine due to certain bone changes, a patient’s weight or physique, and other factors.”  

If a patient is found to have osteoporosis or osteopenia prior to spinal fusion, the treatment plan may be modified, including the type of implants used.

The study enrolled 296 patients undergoing lumbar spine fusion for a degenerative condition or spinal instability.

Fifty-five percent were female, and the mean age was 63 years old, with patients ranging in age from 21 to 89 years old.

Almost 90 years old and they still want to do a spinal fusion surgery? Well, without opioids to ease the pain of spinal nerves being pinched, I don’t suppose these patients don’t have much choice.

It seems that interventional (invasive) pain specialists are making out like bandits now that patients aren’t able to get effective pain relief with medication anymore.

Pain from compressed nerves in the spine can be severe enough to make a patient consent to dangerous surgeries, tissue-destroying epidural injections, long courses of ineffective therapies like acupuncture, or any quackery that promises relief.

Using American College of Radiology criteria,

  • 44 percent of patients were diagnosed with osteopenia;
  • 15 percent had osteoporosis; and
  • 41 percent were diagnosed with normal bone density.

There were no differences in prevalence between gender or race, but patients over age 50 were much more likely to be diagnosed with low bone density.

Of these patients,

  • 49 percent were diagnosed with osteopenia and
  • 18 percent had osteoporosis.

In patients under age 50,

  • no individuals were found to have osteoporosis, but
  • 17 percent had osteopenia.

Within a subgroup of 212 patients with no prior history of low bone density,

  • 39 percent were diagnosed with osteopenia and
  • 10 percent had osteoporosis.

“Spine surgeons should be aware of the high prevalence of abnormal bone mineral density in lumbar spine patients and the possibility that those without a previous diagnosis may have osteopenia or osteoporosis,” Dr. Hughes said.

Diagnosing this prior to spine fusion could lead to a change in surgical planning and treatment, and we believe this would improve outcomes.”

I wonder if this is what causes so many of the failed back surgery syndrome cases. Trying to do spinal fusions when the bones are already deteriorating does not seem a good recipe for success.

7 thoughts on “Undiagnosed Osteoporosis in Spine Fusion Surgery

  1. chalcedony123

    Given the information we know about Immunizations, I wonder what might actually be causing causes this abnormal bone loss leading to osteopenia and osteoporosis?

    Liked by 1 person

    Reply
    1. Zyp Czyk Post author

      Bone less happens from less activity and hormonal factors (menopause) and it happens over years. We almost all have good bones when we’re kids, but without the constant small stresses of physical activity, the bones don’t keep rebuilding their thickness and gradually get thinner and thinner.

      We can blame it on the sedentary lifestyles of our “modern” society – desk jobs are a killer.

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  2. Kathy C

    Could Chalcedony be an Anti Vaxxer? If it were not for vaccines many of these surgical candidates would not have lived long enough to get osteopenia. It is funny they never question soft drink consumption, which has been proven to cause osteopenia in teens. We have to watch out for the Trolls!

    There is a curious absence of research on these procedures. One thing is for sure, they are profitable. When the patients have unintended consequences from these procedures, which includes intractable chronic pain, they can be ignored. A patient reporting pain after one of these procedures, can be classified as having OUD. This is even if they are not even considering opioids. A lot of these surgeries involved implanting medical devices, which were not thoroughly tested. The FDA hid the reports of millions of people who had medical implants too.

    No agency did any research on the incidence of injury, chronic pain, and long term problems. In fact the numbers have not been collected, and no research was done on any of the variables.

    This study shows that many of the people who underwent these procedures, that had osteopenia, were taken advantage of, lied to and defrauded. The literature about “Opioid Alternatives” recommends surgery for chronic pain, they just leave out facts, like the percentage of people who are helped. The industry used the so called opioid epidemic to force these surgeries on vulnerable patients who had pain. Since there is no accountability, and the side effects, outcomes and dangers are not discussed or amplified, people are being exploited. A lot of these surgeries were done on the elderly who had no chance of actually recovering. Some of them were already confined to nursing homes, and wheelchairs.

    This is market driven healthcare at it’s worst, the marketers, liars and propagandist, have absolved the industry of all responsibility. CMS has not tracked any of this, because it could cut into profits for these ghouls. They used the so called opioid epidemic to force thousands of people to undergo dangerous and risky surgeries.

    That “education” means pain pumps, surgery and intrusive procedures, all of them more expensive and less effective than opioids. None of the adverse events from any of these interventions are reported. In fact other than obscure and often proprietary journals, this information is not for public consumption. Corporate media failed to report on any of this in a factual way to protect the industries. We see the same failure to report all of the facts in the coverage of the so called opioid epidemic.

    “Prescription opioids are not the only suitable way to help manage pain. Many alternatives exist, including physical therapy, massage, acupuncture, and other methods. Get educated on alternatives to managing pain and to help make a positive impact on the opioid epidemic.”

    There is no legal requirement for surgeons who took money from factory reps to include device information in the medical record.
    https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfMAUDE/search.CFM

    https://www.dissentmagazine.org/online_articles/opioid-crisis-failure-politics-fda-neoliberalism

    Sites like this show how the elderly are targeted for marketing, Plenty of marketers are already taking advantage of this population.
    https://blogs.scientificamerican.com/observations/marketing-health-care-services-to-older-people-is-tricky/

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    Reply
    1. Zyp Czyk Post author

      Great quote from dissent magazine:
      “It turns out “running the government like a business” in practice amounts to running the government on business’s behalf, at the expense of the public good.”

      That sums up my feelings exactly.

      I think a big part of the problem is that we no longer know where to find reliable information when even scientific research is tainted by bias. This makes us ever more susceptible to clever marketing.

      I blame the overly rich people at the top of our social “food chain”.

      They control so much of our reality and their motives are usually only to enrich themselves further. They are driven by an all-consuming fear of losing anything because the more you have, the more you have to lose. We’re stuck in a self-reinforcing spiral of greed and fear.

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  3. Kathy C

    Zyp,

    Check this out!

    Darnell again, and this one links to the Krebs Study.
    SA has gone to the dark side, where marketing, clickbait and propaganda prevail.

    https://www.scientificamerican.com/article/how-to-break-the-bonds-of-opioids/

    Effect of Opioid vs Nonopioid Medications on Pain-Related Function in Patients with Chronic Back Pain or Hip or Knee Osteoarthritis Pain—The SPACE Randomized Clinical Trial. Erin E. Krebs et al. in Journal of the American Medical Association, Vol. 319, No. 9, pages 872–882; March 6, 2018.

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    Reply
  4. Kathy C

    , Yeah, we can see the results of “running the government like a business. These patients were elderly and frail, and possibly already in nursing homes. They would have been told that they needed surgery, because they could become addicted to opioids. It all depends on the reimbursement rates of their insurance. A lot of these women are probably already dead.

    I knew a woman in her 80s with osteoporosis, she broke on of the vertebrae in her spine and lived with the agony as her physician refused to prescribe pain medication or even acknowledge the incredible pain she was in. This woman was one of the sweetest people I ever met, she raised 4 children, and worked all of her life. Her last years on this earth were spent in agony, as the doctors milked her for every insurance dollar. At least we know it was profitable, as her care cost Medicare hundreds of thousands of dollars, like so many others.

    Seeing how they have monetized this despair and lied to patients should have been charged criminally, but that will never happen, the system is much too corrupt. They have used this social problem to deny care to patients undermine their dignity and ruin lives as they profit. None of those academic researchers are capable of understanding the facts, they need to get approval and funding from the very same corporations that are profiting.

    Our media no longer publishes facts about healthcare, that might be”political.” In my community 30 homeless people died in the ditches again this year, as our local “non profit” religious hospitals took in millions. No one in this community is brave enough to speak up and our politicians are all groveling for their cash.

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