The Impact of Osteoporosis in The Elderly on Surgical Procedures and Complications: A Meta-Analysis Study

Osteoporosis poses a significant challenge to surgical management in the elderly, particularly in spinal procedures where compromised bone quality undermines mechanical stability and increases complication risks where  This comprehensive meta-analysis synthesizes current evidence on the impact of osteoporosis on postoperative outcomes, focusing on fusion rates, mechanical complications, and overall surgical success and according to  The findings consistently demonstrate that osteoporotic patients face elevated risks of hardware-related complications including screw loosening, cage subsidence, pseudarthrosis, and adjacent segment disease. Hence, these complications contribute to longer hospital stays, greater healthcare costs, and a heightened likelihood of revision surgeries. However, the analysis also reveals that when osteoporosis is proactively addressed through pharmacological treatments and surgical techniques optimized for fragile bone, differences in fusion success and functional outcomes are substantially reduced, while in this study, novel diagnostic tools such as MRI-based vertebral bone quality scoring facilitate personalized preoperative risk assessment and surgical planning. Importantly, the evidence underscores the necessity of a multidisciplinary approach integrating endocrinologists, geriatricians, nutritionists, and surgeons to optimize bone health before and after surgery moreover Lifestyle interventions including exercise, fall prevention, and vitamin D supplementation remain foundational for fracture risk reduction and improved musculoskeletal resilience with Collectively, these insights emphasize that while osteoporosis heightens surgical risk in the elderly, meticulous optimization of bone health and individualized treatment strategies can significantly enhance clinical outcomes and quality of life for this vulnerable population.