Recorded Osteoporosis and Subsequent Lumbar Fusion After Lumbar Decompression: A Propensity Score-Matched Cohort Study.

OBJECTIVE

To determine whether a recorded diagnosis of osteoporosis is associated with subsequent lumbar fusion after lumbar decompression.

METHODS

Adults undergoing lumbar decompression during 2010-2020 were identified in the TriNetX Global Collaborative Network. Osteoporosis was defined by ICD-10-CM M80 or M81 recorded on or before decompression. Propensity score matching yielded 5,134 patients per cohort. Subsequent lumbar fusion was assessed through 2 and 5 years after decompression. Hazard ratios (HRs), fixed-horizon event proportions, and all-cause mortality were evaluated.

RESULTS

Fusion occurred in 179/5,134 (3.5%) versus 151/5,134 (2.9%) patients at 2 years (HR, 1.140; 95% CI, 0.918-1.416) and 304/5,134 (5.9%) versus 256/5,134 (5.0%) at 5 years (HR, 1.132; 95% CI, 0.959-1.337). Five-year fixed-horizon proportions differed (P = 0.037), whereas the log-rank test did not (P = 0.143).

CONCLUSIONS

A recorded diagnosis of osteoporosis was not associated with a meaningful difference in subsequent lumbar fusion after lumbar decompression. Further studies are needed to clarify whether osteoporosis influences the clinical course and likelihood of subsequent fusion after decompression.