141 Bone Optimization for the Perioperative Spine Patient: Multidisciplinary Approach at a Single Academic Center

INTRODUCTION: Osteoporosis is a metabolic bone disease that poses challenges in spine surgery due to compromised bone quality. The National Inpatient Sample (NIS) found that osteoporotic patients undergoing cervical spine surgery had a greater chance of revision surgeries and costlier hospitalizations. The aging population and increasing lifespan have led to a rise in osteoporosis, necessitating effective perioperative bone density optimization. METHODS: We conducted a retrospective review of 204 patients referred to our Bone Liaison Service for spine-related reasons between October 2019 and May 2024. All patients complete an intake questionnaire during this first visit. After a full workup (bone health assessment), patients meet with a member of the Bone Liaison Service to discuss treatment options. The study focused on 72 perioperative patients, examining their demographic data, bone health assessments, treatment modalities, and factors influencing treatment choice. RESULTS: Of the perioperative patients, 76.4% were treated post-surgery, and 23.6% were optimizing their bone health preoperatively. Most patients (83.3%) were prescribed medications, with romosozumab being the most common (43.3%), followed by denosumab (26.7%), abaloparatide (23.3%), and teriparatide (13.3%). Treatment choice was influenced by contraindications (45%), patient preferences (11.7%), and insurance coverage issues (11.7%). Factors such as route of administration, dosing interval, and distance to the clinic also played significant roles. CONCLUSIONS: The optimization of bone health in spine patients is influenced by multiple factors, including medical contraindications, patient preferences, and insurance coverage. A multidisciplinary approach is essential for effective management and optimization of treatment outcomes. Further studies are needed to evaluate the impact of bone health optimization on surgical outcomes.