Abstract
Teriparatide belongs to osteo-anabolic compounds and has been used in recent years to treat patients with osteoporosis, with the benefits of increased bone density. Its osteo-anabolic action has led to the investigation of the use of teriparatide for the improvement of bone quality. Apart from the enhancement of fracture union, teriparatide has been extensively studied in the promotion of fusion rate after spinal fusion. This study summarizes the preclinical and clinical results of the off-label use of teriparatide in the spine, and specifically its intermittent administration after instrumented spinal arthrodesis along with its impact on the spinal bone quality and spinal bone mineral density.
Highlights
BackgroundParathyroid hormone (PTH) is a polypeptide consisting of 84 amino acids produced by parathyroids and involved in maintaining calcium and phosphate homeostasis
This study summarizes the preclinical and clinical results of the off-label use of teriparatide in the spine, and its intermittent administration after instrumented spinal arthrodesis along with its impact on the spinal bone quality and spinal bone mineral density
Its unique properties have led to the use of teriparatide as a means to augment spinal fusions, in animal and clinical studies
Summary
Parathyroid hormone (PTH) is a polypeptide consisting of 84 amino acids produced by parathyroids and involved in maintaining calcium and phosphate homeostasis. The recombinant analogue of PTH (rPTH or PTH1-34) or teriparatide has been used since 2002 as an osteoanabolic agent with great success It is the N-terminal portion of PTH, consisting of the first 34 amino acids. Teriparatide promotes the maturation of circulating osteoblast precursors and differentiation of lining osteoblasts, triggers the formation of new bone tissue by the preexisting osteoblasts, and limits osteoblast and osteocyte apoptosis [2]. It seems that it may have a potential role in fracture healing by enhancing various processes involved in the initial formation of endochondral bone and in the construction of the primary callus. The purpose of this paper is to summarize the relevant information from the international bibliography and to draw conclusions about the progress of science in the subject
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