The Connection Between Bone Density & Spine Surgery: What to Know

If you’re a candidate for spine surgery, such as endoscopic spine surgery (ESS), then you should be aware that your bone density (or relative lack thereof) does have an important impact on the risk level of being operated on. 

That’s because the likelihood of optimal surgical outcomes is diminished in patients with less dense bones. The longevity and durability of surgical remedies is also reduced.

Looking for other things you should consider before back surgery? Head to our blog post “10 Questions to Ask Before Back Surgery”. Otherwise, here’s what you need to know about the density of your bones & spinal surgery, and how the two are related. 

What is Bone Density?

Bone density relates to how mineral-dense your bones are, simply put it’s how strong your bone is. 

In the words of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, “Bones containing more minerals are denser, so they tend to be stronger and less likely to break.”

Why Does Density of the Bones Matter to Spinal Surgery?

Because bone density has a causal link with potential for bone breakage and fracture (in other words, the more dense your bones are, the more resilient they are to stress and trauma), it plays an important role in patient outcomes, both during and after spine surgery. 

At Desert Spine and Scoliosis Center, we want you to be informed about all your potential risk factors and available treatment options.

How Does Low Bone Density Affect Surgical Outcomes?

According to a study by Carlson, et. al, published in the National Library of Medicine entitled “A Review and Clinical Perspective of the Impact of Osteoporosis on the Spine”, “Low bone density is associated with poor outcomes in spine surgery.”

The study segments the following potential adverse effects and outcomes associated with low density of the bone:

• “Increased risk of screw[s] loosening, hardware failure, and interbody cage subsidence”
• Implant failure
• “Significantly reduced pullout strength”
• Nonunion (when the lumbar bones detach to such an extent that the stability and the blood flow of the bone are impaired)
• Proximal junctional failure following spinal fusion surgery
• Higher rates of revision surgery in patients with low bone mineral density

The short version? Lower bone density means a lower likelihood of successful surgery.

It’s worth noting that none of the above adverse outcomes is 100% certain to happen, and not all of the above outcomes are necessarily associated with every type of spine surgery. But all of the above are potential negative consequences of undergoing spine surgery with low bone density.

What Other Factors Can Impact Surgical Outcomes?

While there are certainly plenty of other risk factors (including who you choose to operate on you!) that determine the outcome of spine surgery, vitamin D deficiency is another common one worth noting.

In fact, “vitamin D deficiency has been shown to be a prevalent issue that can adversely impact elective spine surgery”, according to the Carlson, et. al study referenced above. 

Does My Bone Density Affect My Candidacy For ESS?

It could. If you have osteoporosis, osteopenia, or another condition that affects your bone density, or you’ve recently taken a bone mineral density test and are concerned about the results and their potential impact on your candidacy for spinal surgery or other back surgery, we invite you to contact us at Desert Spine and Scoliosis Center. We’d be happy to discuss your situation and options with, including surgery alternatives.