April 10, 2014 Dear Colleague:
As a spine surgeon, I see firsthand the extreme weakening of bone caused by osteoporosis. I see it as I repair vertebral compression fragility fractures, and I see it in spinal fusion patients whose grafts take longer to heal because of the weakened scaffold within the bone. Patient after patient with horrible bone degeneration is a rampant problem. Those with strong bones have fewer fragility fractures. They have better spinal surgical outcomes, and their life expectancy is increased. So, I’m pleased to let you know that Michigan Neurosurgical Institute is now providing an enhanced level of pre- and post-surgical care through our new Bone Health Clinic.
Bone Health Clinic Our Bone Health Clinic is designed to help patients avoid future fragility fractures and improve surgical outcomes by working with primary care physicians and other specialists to manage a patient’s osteoporosis. Many patients don’t know they have osteoporosis prior to their spinal surgery, sometimes due to a false negative on their radiologic findings. But once we do surgery—and have a visual and tactile assessment of the bone itself—a definitive diagnosis of osteoporosis can be made. As part of our post-surgical rehab care, our clinical team will follow up with all the documentation necessary to initiate a course of treatment to not just maintain bone, but to grow new bone in some cases. While many patients have heard of bisphosphonates we are working more extensively with parathyroid hormones (anabolic) to stimulate the body to build new bone. It can dramatically improve a patient’s bone health, but has time-consuming and extensive documentation requirements. Our Bone Health Clinic will complete all the necessary paperwork for authorization, as well as follow up with patients and their referring physicians over the course of treatment, which – depending on the most appropriate treatment modality – could involve daily treatment for up to two years. We’re also anticipating that if we “pre-hab” spinal fusion patients with bone-building medications, they will have a higher rate of positive outcomes. For example, if a patient takes the parathyroid hormone (anabolic) for three months prior to spinal fusion surgery with screws, we know that the medication will rebuild bone in the spinal column—giving the surgery a higher success rate than it would have without the medication.