Sidney Roberts, Blake Formanek, Zorica Buser, Jeffrey C. Wang

May 2021, Volume 30, Issue 5, pp 1329 - 1336 Original Article Read Full Article 10.1007/s00586-020-06706-y

First Online: 04 January 2021

The impact of bisphosphonates on postoperative complication rates in osteoporotic patients undergoing posterior lumbar fusion


To elucidate the effects of bisphosphonates on complications following posterior lumbar fusion (PLF) with a large database study.


The PearlDiver Patient Record Database was queried to identify adult patients who had undergone posterior lumbar fusion (PLF). Those patient cohorts were divided based on a diagnosis of osteoporosis prior to surgery and bisphosphonate usage. This yielded three groups: Osteo+Bisph+, Osteo+Bisph−, and Osteo−Bisph−. The primary outcome of the present study was revision rates at 6 months and 1 year following surgery. Incidence of postoperative complications was analyzed, and statistical analysis was conducted using Pearson chi-square analysis.


Patients taking bisphosphonates did not have significantly different rates of revision surgery at 6 months and 1 year, instrumentation complications, or post-vertebral fractures than patients not taking bisphosphonates. Additionally, osteoporotic patients did not have significantly different rates of these complications than patients without osteoporosis.


Bisphosphonate usage did not significantly affect the rates of postoperative complications following posterior lumbar fusion. Further research is required to fully elucidate the effects of bisphosphonates on outcomes and complications following spine surgery.

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