Osteoporosis & bone health

Perioperative teriparatide for preventing proximal junctional kyphosis and failure in patients with osteoporosis after adult thoracolumbar spinal deformity surgery: a prospective randomized controlled trial

Osteoporos IntPublished Randomised controlled trial

Authors' conclusion

Perioperative teriparatide treatment of patients with osteoporosis after ASD surgery effectively reduced PJF incidence and postoperative back pain.

Study context

Population
Patients with osteoporosis planned to undergo adult spinal deformity (ASD) surgery
Participants
64 patients
Comparison
Perioperative teriparatide vs denosumab (active control), from 3 months preoperatively to 3 months postoperatively
Primary endpoint
Proximal junctional kyphosis (PJK) and proximal junctional failure (PJF) incidence within 1 year after ASD surgery
Follow-up
1 year
Methodological detailsprospective, active-controlled
  • Prospective
  • Active-controlled

Primary result

As reported in the abstract

PJK incidence · within 1 year

P = 0.165

Secondary outcomes

PJF incidence (co-primary) · within 1 year · modified intention-to-treat (mITT) analysis

P = 0.034

Bone mineral density (BMD) of the hip · 1-year follow-up

No significant differences between the two groups

Postoperative VAS for back pain and EQ-5D score

Significantly improved in the teriparatide group

Original publication

Perioperative teriparatide for preventing proximal junctional kyphosis and failure in patients with osteoporosis after adult thoracolumbar spinal deformity surgery: a prospective randomized controlled trial. Osteoporos Int. Published 18 March 2025. doi:10.1007/s00198-025-07449-6

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