Effects of Denosumab on Bone Fusion in Osteoporotic Patients After Lumbar Fusion

  • End date
    Oct 22, 2023
  • participants needed
  • sponsor
    Shanghai Changzheng Hospital
Updated on 22 March 2022
vitamin d
bone mineral density
dual-energy x-ray absorptiometry
x-ray absorptiometry


Lumbar fusion is an accepted and effective technique for the treatment of lumbar degenerative disease. As the population ages, disability associated with spinal pathology and spinal surgery is rapidly increasing and there is a concomitant increase in prevalence of osteoporosis which is a detrimental factor for Lumbar fusion and instrumentation. Osteoporosis-related bone fragility is a primary reason for spinal fusion failure, implant fixation failure, and vertebral compression fractures above or below the fusion sites.

Denosumab is a human monoclonal antibody against RANKL, it inhibits osteoclast mediated bone destruction and has been found to be effective in treating osteoporosis, including reducing bone turnover markers, increasing bone mineral density (BMD), and reducing fractures. But few studies focus on the effects of Denosumab on lumbar fusion. In this study, we include osteoporotic patients with lumbar degenerative disease who have had lumbar interbody fusion surgery. The patients were randomized to either treatment of Denosumab or no treatment. All these patients are followed at 3, 6, 9, 12 months postoperation. During these periods, we detect bone metabolism and bone fusion of these patients. Finally, we would report whether Denosumab can improve bone metabolism and promote bone fusion or not.

Condition Osteoporosis, Fusion of Spine, Lumbar Region
Treatment Calcium and vitamin D, Denosumab 60 mg/ml Injectable Solution [Prolia]
Clinical Study IdentifierNCT05203588
SponsorShanghai Changzheng Hospital
Last Modified on22 March 2022


Yes No Not Sure

Inclusion Criteria

Diagnosis of degenerative lumbar diseases with symptoms of low-back pain and/or leg pain for at least 3 months, which was not be adequately controlled by nonoperative treatments
Diagnosis of osteoporosis, defined as a bone mineral density (BMD) at lumbar or femoral neck with 2.5 standard deviations or more below the mean peak bone mass (T scores <-2.5 SD) measured by dual-energy X-ray absorptiometry (DXA)
Patients will be underwent single-level or two-level lumbar interbody fusion

Exclusion Criteria

Paget disease of bone
Low laboratory tests for calcium
Previous radiation treatment or fusion surgery to lumbar spine
Bone tumors
Bone infection
Acute vertebral fractures
Severe spinal deformities such as degenerative scoliosis
Other metabolic bone disease
History of a anti-osteoporosis medication
Combined with severe morbidities
Uncorrected bleeding diatheses
Application of steroids
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