Poster Presentation 50th International Society for the Study of the Lumbar Spine Annual Meeting 2024
Effect of Lumbar Spinal Stenosis on Treatment of Osteoporosis: Comparison of Three Oral Bisphosphonate Therapies (#118)
Introduction
Several studies have shown that lumbar spinal stenosis (LSS) causes various neurological symptoms and reduces the patient’s daily activity, which can negatively affect osteoporosis. The objective of this study was to investigate the effect of LSS on bone mineral density (BMD) in patients treated with one of three oral bisphosphonates (ibandronate, alendronate, and risedronate) for newly diagnosed osteoporosis.
Methods
We retrospectively reviewed data from 1521 consecutive patients treated for osteoporosis. Among these patients, 346 were treated with oral bisphosphonates for three years and were included in this study. Group I included 178 patients treated for osteoporosis alone, and group II included 168 patients treated for osteoporosis and symptomatic LSS. We compared annual BMDs and BMD increases for three years between the two groups. The therapeutic efficacies of the three oral bisphosphonates in each group were also evaluated.
Results
The mean BMDs were similar in the groups at the initial presentation and one-year follow-up. However, the mean BMDs at two- and three-year follow-ups were significantly higher in group I than in group II. Annual and total increases in BMD were significantly greater in group 1 compared to group II (p < 0.05 for all). The total increase of BMD for three years was significantly greater in the ibandronate and alendronate subgroups than in the risedronate subgroup (0.49 vs. 0.45 vs. 0.25, p < 0.001). Ibandronate showed a significantly greater increase of BMD than risedronate in group II (0.36 vs. 0.13, p = 0.018 at post-hoc test).
Discussion
This study revealed that symptomatic LSS may interfere with the increase of BMD in the treatment of osteoporosis. Ibandronate and alendronate were more effective in treating osteoporosis than risedronate. In particular, ibandronate was more effective than risedronate in patients with both osteoporosis and LSS. However, further trials are needed to validate these results.
