Hi Annie

The T-score represent numbers that compare the condition of your bones with those of an average young person. The T-score is usually the most important number to pay attention to. T-scores are usually in the negative or minus range. The lower the bone density T-score, the greater the risk of fracture. Normal bone density is +1 to –1. If the numbers are between –1 and –2.5 you have osteopenia. A score of –2.5 or less is defined as osteoporosis.

The Z score represent numbers that compare the condition of your bones with an average person of your age. A negative Z-score of –2.5 or less should raise suspicion of a secondary cause of osteoporosis. Osteoporosis can be missed in a senior person if the diagnosis is based on the Z-score. The Z-scores help diagnose secondary osteoporosis, which is osteoporosis due to a clinical disorder rather than aging which is the primary cause of osteoporosis.

Your second chart is more important because it is showing your T-scores and that is what the doctors will pay attention to when determining the condition of your bones. It appears that your T-scores have improved in some areas from 2022 and 2020. Did you have all your DEXA scans taken at the same facility?

On January 1, 2024 at age 71 the Bone Mass Density measured at AP Spine (L1-L4) was 0.778 g/cm2 with a T-score of -3.0. I am guessing that the percentage numbers are your 10 year risk of fracture at that location. If I am reading this correctly the upper chart which represents says you have osteoporosis in your lumbar spine in L1-L3. The lower chart suggests that you have osteopenia at those same areas of your spine. I would suggest you ask a doctor to explain your results so that you can fully understand what they mean. I hope I was able to explain the DEXA report well enough for you to understand the basics of what it is telling you.

Osteoporosis has often been considered a contraindication for spinal surgery. Today, advances in surgical and anesthetic technology make it possible to operate successfully on elderly patients who don't want to accept disabling physical conditions. Recent literature suggests the outcomes of surgical treatment are more favorable than conservative treatment. I know you have been searching for some time to find a doctor to do the right surgery, a doctor that you can trust. Your doctor and his team will need to able to treat a person with osteoporosis and have a good deal of experience. Check with US News & World Report for hospital evaluations to find the best hospitals for spinal surgeries. Mayo Clinic has been cited as the #1 hospital in the world. But, there are other good doctors and hospitals around the country. I know that the Cleveland Clinic is well known for spinal surgeries and also fusions. I would look at a teaching hospital or one that has a lot of research going on. Ask your friend about the doctor she saw too. The orthopedic doctor who did my fusion surgery is widely known for his research on bone health, regeneration, and engineering human bone.

Taking time to decide on surgery is a good idea. Doing research and asking lots of questions is very important. If you are going to have surgery, I would recommend doing it sooner rather than later. My mother had osteoporosis in her hips and when she finally decided to have a needed surgery, it had to be repeated the next day because the bone damage wasn't found until the doctor was in the operating room. She had a successful surgery but it took months longer for her recovery.