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Restoration of Bone Turnover Rate After Decompression Surgery in Patients With Symptomatic Lumbar Spinal Stenosis: Preliminary Report

Kim, Ho-Joong, MD*; Lee, Hwan-Mo, MD*; Chun, Heoung-Jae, PhD; Kang, Kyoung-Tak, MS; Kim, Hak-Sun, MD*; Park, Jin-Oh, MD*; Moon, Eun-Su, MD*; Park, Kwang-Hwan, MD*; Moon, Seong-Hwan, MD*

doi: 10.1097/BRS.0b013e3181ab3e88
Basic Science

Study Design. Prospective short-term longitudinal study.

Objective. To investigate changes in the bone turnover rate in patients with lumbar spinal stenosis (LSS) before and after decompression surgery.

Summary of Back ground Data. Decompression surgery enables elderly patients with LSS to participate in daily activities and physical exercise by reducing or alleviating leg and back pain. However, there have been no studies to date regarding the effect of decompression surgery on bone metabolism in such patients.

Methods. Twenty-three patients with spinal stenosis who were scheduled to undergo decompression surgery were enrolled in our study. Ten patients were given oral bisphosphonates after the operation (B+ group), while the remaining 13 patients did not receive oral bisphosphonate (B− group). In both groups, walking distance without rest, the Oswestry Disability Index (ODI) scores, duration of symptoms, bone formation, and resorption markers, and bone mineral density were recorded before surgery. Three months after surgery, bone turnover markers, a single trial for walking distance without rest and ODI scores were measured for both groups.

Results. Three months after the operation, the bone resorption marker u-NTx was decreased significantly for both groups. Although there was a decrease in bALP, a bone formation maker, in both groups, the change in each group was not statistical significant. Distance in a single trial walk was increased and ODI scores were decreased significantly for both groups.

Conclusion. This study suggests that decompression surgery has a beneficial effect on bone metabolism in patients with LSS who have walking intolerance and limited physical activity.

In the present study, we clearly demonstrate that improved physical activity after decompression surgery in patients with lumbar spinal stenosis can improve bone metabolism and reverse the already increased rate of bone resorption caused by decreased physical activities in these patients.

From the *Department of Orthopaedic Surgery, Yonsei University College of Medicine, Seoul, Korea; and †Department of Mechanical Engineering, Yonsei University, Seoul, Korea.

Acknowledgment date: September 29, 2008. Revision date: January 17, 2009. Acceptance date: February 25, 2009.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

Foundation funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

H.J.K. and H.M.L. contributed equally to this work.

Supported by the AOSPINE research fund and by the Basic Research Program of the Korea Science and Engineering Foundation (No. R01-2006-000-10933-0) and by the Brain Korea 21 Project for Medical Science at the Yonsei University.

Address correspondence and reprint requests to Seong-Hwan Moon, MD, Department of Orthopaedic Surgery, Yonsei University College of Medicine, 134 Shinchondong, Seodaemunku, Seoul, Korea; E-mail:

© 2009 Lippincott Williams & Wilkins, Inc.