Efficacy of anti-osteoporosis therapy after anterior surgery for cervical spinal tuberculosis

To assess the effect of postoperative anti-osteoporosis therapy on titanium mesh subsidence and bone fusion time after anterior cervical surgery for spinal tuberculosis. In this retrospective study, 66 patients undergoing anterior cervical debridement with bone grafting and fixation (2020–2024) were divided into two groups: Group A (full-course anti-osteoporosis therapy, n = 33) and Group B (no/incomplete therapy, n = 33). The primary endpoints were titanium mesh subsidence and bone fusion time. Secondary endpoints included VAS score, NDI score, Frankel grade, bone mineral density, and radiographic alignment. Clinical and radiographic outcomes were compared. The mean follow-up was 12.5 months. Neurological function (Frankel score) improved in all patients. The titanium mesh subsidence rate was significantly lower in Group A (21.2%) than in Group B (45.3%). Bone fusion time was significantly shorter in Group A (3.5 ± 0.3 months) versus Group B (4.8 ± 0.5 months). Both groups showed significant improvements in VAS and NDI scores. Radiographic alignment was satisfactory. Bone mineral density improved significantly in Group A compared to both its baseline and Group B. Anterior cervical surgery is effective for spinal tuberculosis. Postoperative standardized anti-osteoporosis therapy further improves outcomes by reducing implant subsidence and accelerating bone fusion, offering significant clinical benefit.