{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T03:24:59Z","timestamp":1789010699098,"version":"build-2803163510"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T00:00:00Z","timestamp":1771027200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Spine Deform"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Though the use of anabolic bone agents has proven effective in adult spinal deformity (ASD) surgery, prescription and approval of these medications remains a challenge. In osteopenic\/osteoporotic patients undergoing ASD surgery, we sought to determine the impact of a bone optimization clinic on: (1) prescription patterns of anabolic agents, (2) mechanical complications, and (3) reoperation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study (2009\u201323) was performed for osteopenic\/osteoporotic patients undergoing ASD surgery with\u2009\u2265\u20092-year follow-up. The study period was binarized into before\/after a bone optimization clinic was established (2009\u201319 vs. 2020\u201323). The primary outcomes were: (1) use of anabolic agents prior to surgery (Teriparatide, Abaloparatide, and Romosozumab-aqqg), (2) mechanical complications, and (3) reoperation. Multivariable regression controlling for age, sex, body mass index, and operative time was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 126 patients (mean age 68\u2009\u00b1\u200910yrs; 86% female) undergoing ASD surgery with osteopenia (80%) or osteoporosis (20%), 91 (72%) were before the bone optimization clinic and 35 (28%) were after. Similar rates of osteoporosis in both groups were seen (pre-21% vs. post-17%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.638). After the bone optimization clinic, more patients received preoperative anabolic therapy (54% vs. 23%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and for a longer duration (98\u2009\u00b1\u2009156 vs. 40\u2009\u00b1\u2009109\u00a0days,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.027). Overall mechanical complications decreased significantly (49% vs 81%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) as did reoperation for mechanical complications (6% vs. 44%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariable regression showed that a bone optimization clinic independently improved the use of preoperative anabolic agents (OR\u2009=\u20095.3, 95%CI:2.1\u201313.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and reduced the risk of mechanical complications (OR\u2009=\u20090.2 95%CI:0.1\u20130.5,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and reoperation for mechanical complications (OR\u2009=\u20090.1, 95%CI:0.1\u20130.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In osteopenic\/osteoporotic patients undergoing ASD surgery, a bone optimization clinic was independently associated with increased prescription rates and duration of anabolic bone agents, reduced mechanical complications, and reduced reoperation for mechanical complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s43390-026-01307-z","type":"journal-article","created":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:07:36Z","timestamp":1771038456000},"page":"821-829","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["A bone optimization rheumatology clinic increases anabolic bone agent use and reduces mechanical complications in adult spinal deformity surgery"],"prefix":"10.1007","volume":"14","author":[{"given":"Harsh","family":"Jain","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Advith","family":"Sarikonda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranbir","family":"Ahluwalia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Zakieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Navid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Raj","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clayton R.","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Chanbour","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iyan","family":"Younus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tyler","family":"Zeoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soren","family":"Jonzzon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Autumn","family":"Zuckerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Bobo Tanner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian G.","family":"Lugo-Pico","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir M.","family":"Abtahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byron F.","family":"Stephens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2951-2942","authenticated-orcid":false,"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,14]]},"reference":[{"key":"1307_CR1","doi-asserted-by":"publisher","DOI":"10.3171\/2025.4.FOCUS25245","volume":"59","author":"S Sundrani","year":"2025","unstructured":"Sundrani S, Doss DJ, Johnson GW, Jain H, Zakieh O, Wegner AM, Lugo-Pico JG, Abtahi AM, Stephens BF, Zuckerman SL (2025) Does alignment alone predict mechanical complications after adult spinal deformity surgery? 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Dr. Abtahi receives institutional research support from Stryker Spine. Dr. Stephens receives institutional research funding from Globus, has received institutional research funding from Stryker, and is an editorial board member for the research journal Spine Research. No other perceived conflict of interest by any of the listed authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"Waived due to the retrospective nature of the study.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}