{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T06:02:36Z","timestamp":1789624956210,"version":"build-2803163510"},"reference-count":42,"publisher":"The Korean Spinal Neurosurgery Society","issue":"4","license":[{"start":{"date-parts":[[2025,12,31]],"date-time":"2025-12-31T00:00:00Z","timestamp":1767139200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["e-neurospine.org"],"crossmark-restriction":true},"short-container-title":["Neurospine"],"published-print":{"date-parts":[[2025,12,31]]},"abstract":"<jats:p>Objective: Implant fixation in osteoporotic bone presents substantial challenges due to reduced bone mass and compromised microarchitecture. This study investigated whether romosozumab, a sclerostin inhibitor, improves osseointegration and mechanical stability of cancellous bone screws in glucocorticoid-induced osteoporosis.Methods: Fifty-five New Zealand white rabbits were enrolled. Osteoporosis was induced via either bilateral ovariectomy or weekly intramuscular glucocorticoid injections (4\u20138 mg\/kg). Based on bone mineral density results, glucocorticoid injection was selected for experimental induction. Rabbits were divided into 5 groups: control, untreated osteoporosis, parathyroid hormone (PTH), PTH combined with denosumab, and romosozumab. Cancellous bone screws (4.0-mm diameter, titanium alloy) were bilaterally inserted into the iliac bones. Antiosteoporosis treatments were administered for 3-week postimplantation. Histomorphometric evaluation of bone-to-implant contact (BIC) and bone area fraction occupancy (BAFO) was performed using nondecalcified sectioning and Goldner trichrome staining. Biomechanical pull-out testing measured resistance at 1-mm displacement using a standardized setup on the MTS system.Results: The romosozumab-treated group exhibited superior outcomes. BIC reached 21.2%\u00b118.1%, and BAFO was 56.9%\u00b19.9%. Pull-out strength significantly increased to 275\u00b155 N in the romosozumab group, outperforming PTH (184\u00b161 N), PTH+denosumab (202\u00b123 N), and untreated osteoporosis (120\u00b133 N). Enhanced collagen structure and neobone formation were observed histologically around implants.Conclusion: Romosozumab significantly enhances cancellous bone screw fixation strength and osseointegration in glucocorticoid-induced osteoporotic bone. These findings suggest its clinical potential as an adjuvant therapy in improving spinal implant outcomes in osteoporotic patients.<\/jats:p>","DOI":"10.14245\/ns.2550774.387","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T23:10:08Z","timestamp":1767136208000},"page":"880-890","update-policy":"https:\/\/doi.org\/10.14245\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Romosozumab Enhances Implant Stability in Glucocorticoid-Induced Osteoporotic Bone: A Rabbit Model 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