Osteoporosis and the Management of Spinal Degenerative Disease

Osteoporosis has become a major medical problem as the aged population of the world rapidly grows. Osteoporosispredisposes patients to fracture, progressive spinal deformities, and stenosis, and is subject to be a major concernbefore performing spine surgery, especially with bone fusions and instrumentation. Osteoporosis has often beenconsidered a contraindication for spinal surgery, while in some instances patients have undergone limited and inadequateprocedures in order to avoid concomitant instrumentation. As the population ages and the expectations of older patientsincrease, the demand for surgical treatment in older patients with osteoporosis and spinal degenerative diseasesbecomes progressively more important. Nowadays, advances in surgical and anesthetic technology make it possible tooperate successfully on elderly patients who no longer accept disabling physical conditions. This article discusses thebiomechanics of the osteoporotic spine, the diagnosis and management of osteoporotic patients with spinal conditions,as well as the novel treatments, recommendations, surgical indications, strategies and instrumentation in patients withosteoporosis who need spine operations.