My spine surgeon was "reluctant" to do a lumbar fusion because of my long term prednisone use. He seemed to be most concerned about osteoporosis and wanted a bone scan done first. The surgeon was not so sure that my spine would hold all the hardware that would be needed to fuse my lumbar spine.

I had a t-score of a +5 in the area of my lumbar spine. The spine surgeon said I had a lot of bone but "it wasn't good bone."

The issue of delayed healing and an infection were other concerns the spine surgeon had because of my prednisone use. The issue of adrenal insufficiency and potential for an adrenal crisis was a concern for any surgery not just a lumbar fusion.

When I took 60 mg of prednisone and the sciatic pain went away, the criteria for the lumbar fusion was that "pain would be the deciding factor." The "emergency" lumbar fusion was postponed.

My lumbar spine is a disaster zone but I don't have that much pain anymore. I have numbness and lower extremity weakness but not too much pain. Now the surgeon says it "isn't about the pain anymore."

I'm off prednisone thanks to a biologic called Actemra. Now the surgeon says the surgery should be done sooner rather than later. I would still need to skip one monthly infusion of Actemra in order to do surgery. I could probably skip a month of Actemra but I refuse the lumbar fusion.