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Anyone had surgery on spine who also has osteopenia or osteoporosis

Posted by Twocoastsm @marlenec, Dec 10, 2022

I have a double whammy. I have spondylolisthesis at L4/L5 and it causes some sciatica/left knee and leg pain that I’ve treated with epidural injections with some relief and with physical therapy. An orthopedic surgeon and two neurosurgeons have said that the only way to fix this when I’m “ready” is a fusion. I also have osteopenia - not osteoporosis yet. Took the oral meds for years and was taken off due to stable scans and some improvement. Density has decreased somewhat since two years ago and internist wants to start medication but I have reflux so she sent me a hematologist for injections - she told me that I can’t take the oral meds anymore and all she can do is Prolia. I’m reluctant so am waiting to see a new endocrinologist (I moved and had to find a new one). Wondering how anyone who has had a fusion has fared if their bone density was also low?

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ga29 | @ga29 | Feb 25 5:16am
In reply to @siamesevet "My surgeon is recommending a two stage surgical procedure. Day 1 would involve replacing the discs..." + (show)
@siamesevet

My surgeon is recommending a two stage surgical procedure. Day 1 would involve replacing the discs at L4-L5 and L5-S1. Day 3 would be a lumbar fusion from L2 to the pelvis.
MRI indicates : severe lumbar stenosis L3-L4 central, left L4-L5 lateral
recess, bilateral L5-S1 recess
- L2-L3 dynamic, L3-L4 les dynamic high grade
retrolisthesis
-Left L4 IAP ventral subluxation and coronal
angulation =low grade rotatory spondylolisthesis
-thoracic hyperkyphosis, 60 degrees
-Left L5>S1 lumbar radiculopathy
-Lumbago
-prior left L1, L2 transverse process fractures
-T11 wedge fracture, fragility= clinical osteoporosis

I am a 58 year old female who has pins and needles in the left foot. I struggled with a painful bout of sciatica this summer but it resolved over the summer with gabapentin. I go to the gym daily to use the treadmill and and the weight machines. I started Eventity in December for osteoporosis and seem to be tolerating it well. My bone density tests have always been normal. However, I couldn't argue with see thru appearance of my bones on the radiographs.

The local neurosurgeon recommended an outpatient surgery which seemed minimally invasive. I was utterly taken aback by the 2nd neurosurgeons opinion. I am scheduled for a 3rd opinion with another local neurosurgeon next week and hoping for an additional referral to the state university hospital.

When I walk, after about 10 minutes it feels as if someone is continually tightening my shoelaces on the pins and needles foot. I also have poor balance and some lower back pain which resolves with sitting.

Lastly, I need a new knee on the left side.
Any thoughts would be appreciated.

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Hello, I can only tell you my experience, as your back issues are more serious than mine. I have osteoporosis, and am improving after my second fusion in July, 2023. The first was an L4-5 fusion in January, 2021, but it did not stop the pain. I still had problems with walking, bending, sitting, and nerve pain, numbness down my left leg, burning in my feet when wearing shoes, which the second surgery helped with. I went to Mayo in Jacksonville, the neurosurgeon removed the hardware at L4-5, then extended fusion down to L5-S1. The pain was improved, but I still had nerve pain radiating down my left leg. After three months I went to PT and started strengthening my core. The nerve down my left hip and leg was so bad, then one of the PT interns started pressing on the worst spot in my spine, and it helped a lot! I’ve continued doing that with a child’s tennis ball and the wall, that way the pressure can be adjusted. It’s returning my life back to normal, I’m getting out, riding my e-bike with my husband, getting off the bed more than being in it!
I encourage you to find the best neurosurgeon and get that fusion done. I’ve been in pain since 2011, gradually getting worse. It’s lifting my depression up and off, something we don’t like to talk about. I wish you the best.

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