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Building bone before massive spinal surgery
I have severe osteoporosis, and adult onset scoliosis. On July 13, 2025, I had a high impact fall that greatly destroyed my already compromised spine. I have been bedridden since, finally cleared for PT a month ago, and am more mobile, but in 24/7 pain, worsening when standing, worse agony while sitting. My L1 vertebrae received a wedge fracture, which, after the fracture healed, caused kyphosis to become much more pronounced, and as a result, the ribs attached from there are collapsing forward, “sitting on my pelvis”, as the orthopedist described.
There is strange, intense pain in the frontal ribs from the wedge shaped fracture.
After multiple, multiple efforts with osteopaths, Feldenkrais, PT, gentle exercise walking, Alge Cal, et al, surgery seems the only option now. I am terrified, suspect and trying to find courage.
First step is to see an endocrinologist tomorrow to determine which bone building drug to take. More terror. I do not know how to pay for these expensive drugs, I am on Medicare, which I doubt my Part D plan will pay. And two, side effects. I have had intractable migraine since age 5, am 74 now. If headaches as a side effect tip that scale I cannot go on. The migraines are diabolical, lasting for days in blinding pain. . I have one new med that sometimes aborts ~ I’ve taken every migraine med to no avail.
I would appreciate any help / suggestions about Forteo and the other new bone building drug and any other helpful input. I have great access to the dark side, so in relation to the surgery, which is extensive, 🌟PLEASE no horror stories, I know them all. Thank you for understanding.
There are two thoughts: one is to have the surgery soon, taking the bone support drug alongside; the other is to take the med for awhile to build bone, then do surgery. The issue is, my spine has gotten much worse, about 40%, since the fracture healed and complications arose, so waiting means more worsening. Not waiting means possibility of the bones not being strong enough to support the hardware put into the spine, so more fractures, more surgeries.
I do not know how my life has come to this point. I am an active woman, potter, art teacher, yoga teacher… and now this.
Thanks to all for any thoughts.
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lorac 74, I'm so glad your husband is getting help. I'm keeping him in my thoughts and prayers.
@lorac74 thank you. Ok that puts me in deep terror because we can pay zero per month for meds and my supplement Part D plan is horrible = Silver Script (was great) bought by Aetna ( horrible) and now further wrecked by governmental damaging restrictions.
I am at University of California San Francisco Spine Clinic which is top rated in the US. I am just wondering whether orthopaedic or neuro surgeon is better and will get 2 more opinions. . I would have the same levels as your dear husband. 💚
@redlo
Hi and thank you. Unfortunately I dint know what all the technical terms mean eg, P1np & CTX & Mc Cormick… but it seems the gist is your bones are stronger but density isn’t? It’s all so mysterious… and frightening.
Yes the surgeon I’ve been seeing wanted surgery asap especially because the wedge fracture is in L1, and has the tail end of the spinal cord in it… if damaged further it could cause paralysis. But the endocrinologist u saw yesterday for the first time thinks my bones would not hold. The surgeon said he prefers to do the surgery alongside the start of taking bone building meds. The endocrinologist was clear, 6 months minimum on Evenity.
@margaretisabel We are going to Vanderbilt University Medical in Nashville TN. He is an orthopedic surgeon. He just finished an operation like my husband is having. This patient was 70 and he showed us the after X-rays. So much improvement. We are praying for my husbands to be this successful.
Also we have WellCare as our Part D insurance. But our choices are limited in Tennessee. Prayers it all works out.
I am on my 3rd month of daily Tymlos Injections. Similar to your situation, I was surprised to learn that osteoporosis in my lumbar spine currently makes surgery too risky.
Regarding the cost, I too have Medicare Parts A, B, Gap/Supplement and Part D Prescription. A pharmacist recommended I apply for copay assistance. The application was easy, and acceptance was fairly fast. My application results = zero copay. $0/month. I really didn't think we would qualify so I encourage you to try. Try searching for: Radius Assist Patients Assistance Program, and/or Tymlos Patient Savings Card, or Prescription Hope. Hopefully the other bone building meds offer assistance, if needed, too.
I do my injections in the morning and have not noticed any negative side effects thus far. Blessings
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3 Reactions@dandyideas thank you!
The endocrinologist I saw wants me to try Evenity so I’m gearing up for that. I have to go to an u fusion center once a month.
I will talk to my pharmacist who I dearly appreciate, he is so helpful. You got an amazing response for copay! Sounds like you applied directly to Tymlos? I will check out the tigers. Are Radius Assist and Prescription Hope both separate from Tymlos ?
I’m on my 11th month I soon go for scans to see if it did its job. I’m confident it did.
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1 Reaction@gofishto
Hi, and thank you! Do you mean you are using Evenity? Curious how side effects have been for you?
And, after 11 months, have you experienced a lessening of spinal pain?
@margaretisabel I have RA, osteoporosis and severe neuropathy head to toe. No lessening of pain. I do go next to get my scan pretty hopeful that it helped. I probably will go back on Prolia
I am writing from my hospital bed at Novant Forsyth Medical Center in Winston Salem, NC. I had reconstructive spine surgery a few days ago. I had no choice in this since my spine was rapidly deteriorating. It was this or a life of pain and limited mobility. I have had age-related scoliosis for several years, but two spontaneous fractures last February precipitated my journey to having surgery. Each of the four surgeons that I consulted recommended staying on this drug for at least 6 months for the best surgical outcome. I survived the side effects for that time and a couple of months ago my surgery was scheduled. It has been a long and painful journey, but one that I hope will lead to a bettor quality o life than I otherwise would have had,
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