I’m 77-years young and expect to live to be 100+. But I do have osteoporosis and a spinal curvature that’s causing considerable pain. My surgeon has recommended a spinal fusion to stabilize the spinal curve. Is it safe to do this kind of surgery on a spine that is osteoporotic?

That is a good question and one that is being studied at various centers around the world. Most recently, there was a study from Japan investigating the relationship between scoliosis and osteoporosis.

The authors were interested in finding out if women with scoliosis were more likely to develop osteoporosis as a result of having the scoliosis. Other studies have suggested a link between osteoporosis and scoliosis. Does it go both ways?

They also analyzed the data to see if osteoporosis in adult women with scoliosis affects the final results of surgery. Success of the fusion, number and type of complications, and final scoliosis curve were used as measures of surgical outcomes.

They reported that the amount of bone loss in adult women with scoliosis was pretty much the same (no statistical difference) as women the same age who did not have scoliosis. As far as the results of the spinal fusion surgery, the fusion rate was excellent (93 per cent). The complication rate was 13.6 per cent. There was not a statistically significant relationship between the presence of osteoporosis and number of complications.

The authors think that the results of this study may help prove that adult scoliosis does not occur as a result of osteoporosis in postmenopausal women. And along the same lines, the spinal curvature won’t get worse if osteoporosis is present. It’s more likely that advancing age is the main reason why scoliosis curves develop and/or get worse in older women.

They suggest that having osteoporosis will not prevent bone fusion after spinal surgery. The bottom-line is that women (especially older women who have gone through menopause) can have spinal fusion for scoliosis. The procedure is safe and unaffected by the weaker bone structure so common in this age group. Further study on a larger number of patients including men is needed.

Your surgeon is really the best one to advise you. He or she will take into consideration all your individual risk factors (age, general health, severity of scoliosis and osteoporosis, activity level, mental function and so on). Don’t hesitate to ask this question — it’s a good one!