@annie1 Annie, my mom with severe osteoporosis has a DEXA scan of -4, and I see your lowest DEXA number is -3. The spine DEXA for you says -2.4 which is close to the score for osteoporosis that starts at -2.5. I can understand why the surgeon is concerned. From what I've read this can change for the worse. Only your treating specialist knows if your scores are changing for the better and how to interpret them for your care. You bone quality could be moving toward better or worse and has to be monitored because if you were to stop treatment for osteoporosis, it likely would begin to degrade again according to what I've read on Mayo's website. I've also read that if bone were to crumble after spine surgery, that may make the problem un-fixable.

I believe that when my mom broke her foot and her pelvis (when she fell on the kitchen floor) that her foot probably fractured when she stepped on it and caused the fall. She didn't twist her ankle, but just lost her balance and fell on her side which fractured her pelvis in 3 places. Several years later she had a spontaneous spine compression fracture in her lumbar spine. I hope that gives you a frame of reference for possible risks associated with DEXA scores. My mom does use a wheelchair, and doesn't have weight bearing exercise now because she can hardly walk. She has arthritic deformity in her feet.

Are you having difficulty walking? With the uneven gait due to spinal stenosis, I was wondering if that affected your ability to do weight bearing exercise that is beneficial for bone building? I know you like swimming, but that doesn't help osteoporosis as much because you don't stress the bones with added weight and pressure during movement.

In searching Mayo Clinic information I found that smoking, alcohol use, thyroid problems, steroid use, and some medications can contribute to thinning bones. I did find this interesting article describing regenerative medicine research at Mayo to try to fix thin bones in spine patients. At the end it has links to the labs and departments doing this research. I don't know what is possible today for patient treatment or if this is just an experimental stage, but you may want to look at this. Here are some of the links I found interesting.
https://www.mayoclinic.org/medical-professionals/neurology-neurosurgery/news/optimizing-bone-health-before-complex-spinal-surgery/mac-20542607
https://www.mayoclinic.org/medical-professionals/endocrinology/news/new-tools-to-predict-fracture-risk/mac-20430573
https://newsnetwork.mayoclinic.org/discussion/tuesday-q-a-treatment-for-bone-disorders-focuses-on-strengthening-bones-slowing-bone-loss/
Jennifer