1202 Evaluation of Hardware Complications for Patients on Teriparatide in the Setting on Long Segment Spine Fusions

INTRODUCTION: The long-term stability of constructs used in the treatment of adult spinal deformity requires successful osteogenesis. In the setting of osteoporosis, bony fusion is less robust placing patients at risk of hardware-related complications. Teriparatide is a pro-osteogenic anabolic agent used to improve bone quality in patients with osteoporosis and is commonly used pre-operatively in patients with low bone density undergoing deformity correction. METHODS: Patients diagnosed with adult spinal deformity as defined by the SRS-Schwab classification who underwent long segment thoracolumbar spine surgery between 2016 and 2020 were included in this study. Inclusion criteria include age > 17, > 5 levels of fusion, and use of pelvic instrumentation. A retrospective chart review was performed collecting demographic, radiographic, and treatment-related data. Statistical analysis was performed using Student T-test and Fishers Exact Test. RESULTS: There were 91 total patients that fit inclusion criteria. 22 patients received teriparatide prior to surgery and 69 patients did not. Demographic differences were observed between the teriparatide group and non-teriparatide group with regards to sex (36% male and 55% male respectively, p=0.013) and BMI (28.01 and 31.92 respectively, p=0.026). Pre-operative DEXA scan T-score was different between groups with an average score of -1.81 in the teriparatide group and 0.01 in the non-teriparatide group (p<0.001). Instances of pedicle screw loosening, iliac screw loosening, rod fracture, proximal junctional kyphosis requiring reoperation, or any hardware failure requiring reoperation were not significantly different at one year, or two years. CONCLUSIONS: The use of teriparatide prior to surgery for adult spinal deformity in patients with osteoporosis results in a similar complication profile to those without osteoporosis and/or teriparatide use.