Anyone had spine surgery who 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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Profile picture for maryyg67 @maryyg67

@annie1 yes I have osteoporosis.but bone scan shows normal bones. I am having done at. corwell formerly Beaumont in Royal Oak Mi

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@maryyg67 I’m sorry I have osteoarthritis not osteoporosis.

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Profile picture for annie1 @annie1

Hello All,I have written here many times, but I thought I should have put the question out, who has had successful fusion surgery that has osteoporosis also and where did you have it done ? You have to private message me to give names of Dr's. Thanks much

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My daughter has osteoporosius and after badly fracturing her back she had first 1 spinal fusion, then another 4 years ago. She had limited options because the break was so complex and she could have ended up in a wheelchair. The pedicle screws started coming out almost immmediately and she is in terrible pain. You can actually see 2 of the screws protruding from her back and she is getting wound care for it every 2 days. She had a bad experience with her orthopedic surgeon but no other doctors want to get involved. She has other health issues and it would be dangerous to have the hardware removed. Apparently scres coming loose is not uncommon, expecially with someone who has osteoporosus. As others have said, it is an individual choice but explore all options. Good luck.

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Profile picture for jeanib @jeanib

My daughter has osteoporosius and after badly fracturing her back she had first 1 spinal fusion, then another 4 years ago. She had limited options because the break was so complex and she could have ended up in a wheelchair. The pedicle screws started coming out almost immmediately and she is in terrible pain. You can actually see 2 of the screws protruding from her back and she is getting wound care for it every 2 days. She had a bad experience with her orthopedic surgeon but no other doctors want to get involved. She has other health issues and it would be dangerous to have the hardware removed. Apparently scres coming loose is not uncommon, expecially with someone who has osteoporosus. As others have said, it is an individual choice but explore all options. Good luck.

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@jeanib
I'm so sorry your daughter is in so much pain and the other doctors don't want to get involved. But I'm beginning to see that spine surgeons are not always honest and don't really want to work on people who have complicated issues like your daughter and myself. It's very horrifying. I've thought of going to Europe but of course that would be very expensive since my health insurance wouldn't pay for anything there. As of now I am not doing the surgery but I do have pain after I walk and very disturbed sleep. It's hard living in this no person land not knowing what to do and who to trust with my body.

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Profile picture for tiny28 @tiny28

@annie1 hello Annie, this is difficult to answer . Firstly , do you have any other health issues that might hinder your recovery ? You do realise that a double major op will be a very long recovery with no guarantees. I have been in terrible pain with my lower sacrum for five years with deprivation and continued pain but the only thing that seemed to show up on my scans was L4/5 degenerative disease with bone growth so I decided to have the operation. My surgeon is a professor so very skilled. As I said before I am four months post op ALIF and my pain is considerably worse than it’s ever been!! I now have leg weakness and stiffness also . I feel like my life is over . If you have osteoporosis and are considering rods , screws and cages with two ops then I can only wish you luck and hope that your recovery is better than mine . I have nowhere left to turn now as I don’t have the strength to fight it anymore . You are younger so it may be ok but please think very carefully and let me know your decision . Regards .

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@tiny28
I'm so sorry you're in more pain now! I guess your surgeon knows this right? Does he say it's going to get better? What do you do for the pain? And I forget where did you have this done. You said the surgeon was very skillful but I guess that doesn't mean they can prevent you from being in pain. I am on Evenity to build bone and I just had my 8th shot today. I am not moving ahead with surgery yet. I hired a patient advocate who worked in the OR with spine surgeons and knows somewhat what goes on and the different types of fusions and he was suggesting that I still keep trying conservative methods like epidural injections and physical therapy until my pain is unbearable almost all the time. Which is not but I do have a limited life in terms of not being able to walk very far without it causing me throbbing in my legs and sometimes my whole body. Anyway I'm really sorry to hear your suffering and I hope it gets better! Let me know how you're doing.

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Profile picture for annie1 @annie1

@tiny28
I'm so sorry you're in more pain now! I guess your surgeon knows this right? Does he say it's going to get better? What do you do for the pain? And I forget where did you have this done. You said the surgeon was very skillful but I guess that doesn't mean they can prevent you from being in pain. I am on Evenity to build bone and I just had my 8th shot today. I am not moving ahead with surgery yet. I hired a patient advocate who worked in the OR with spine surgeons and knows somewhat what goes on and the different types of fusions and he was suggesting that I still keep trying conservative methods like epidural injections and physical therapy until my pain is unbearable almost all the time. Which is not but I do have a limited life in terms of not being able to walk very far without it causing me throbbing in my legs and sometimes my whole body. Anyway I'm really sorry to hear your suffering and I hope it gets better! Let me know how you're doing.

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@annie1 hi again Annie, I forgot to tell you last time that I had the op done in a top London hospital . Did I tell you that I also have ME/CFS plus fibromyalgia!! These things all contribute to a lot of pain etc so my recovery all things considered is ok at this stage , I am doing about 5000 to 6000 steps a day . My pain varies day to day as I get flare ups . Unlike yourself I will not take osteoporosis drugs and am only taking Fortibone plus a little calcium and vit D. I eat a healthy diet but can’t really do dairy . My BMI is quite low at 17.4. However I have exercised all my life up until recently which I miss dreadfully !! Anyway at 75 even though I look younger I think I have to expect a few things wearing out!! I wouldn’t consider another surgery 360 fusion from the posterior approach as I would never recover . I wish you luck with your Evenity shots and it’s good that you do t suffer any side effects . I agree you should definitely do what your advisor suggests before surgery.My surgeon is lovely and very caring but at the end of the day it’s down to whatever your body can handle as you age . 😊

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Profile picture for annie1 @annie1

Hello All,I have written here many times, but I thought I should have put the question out, who has had successful fusion surgery that has osteoporosis also and where did you have it done ? You have to private message me to give names of Dr's. Thanks much

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I always get a second opinion! The first surgeon I saw told me I needed a 360 because I have a slipped disc (stenosis too). I have seen two surgeons since and they both recommended a fusion of L 4-5 and a laminectomy. I have an appointment consultation to see if I can have the TOPS procedure instead of a fusion. The recovery time is less and since I live alone, it would be extremely hard to take care of myself, my home and my yard for the first year. I had osteoporosis and just finished the Forteo injections. My back is now strong enough and I am no longer in the range of osteoporosis. Good luck with your procedure!

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Profile picture for annie1 @annie1

Hello All,I have written here many times, but I thought I should have put the question out, who has had successful fusion surgery that has osteoporosis also and where did you have it done ? You have to private message me to give names of Dr's. Thanks much

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I am 73 and have osteoporosis. I have had stenosis of lumbar spine with degenerative disc disease, foraminal stenosis, radiculopathy etc. my main symptom is that my calf muscles throb painfully after walking even if it's just a few steps. I had a laminotomy to me without fusion but now I was told I need fusion however several surgeons have warned that with my osteoporosis that could be risky. How many people out there have had successful fusion with osteoporosis. I would need three levels fuse. Thanks

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Profile picture for annie1 @annie1

I am 73 and have osteoporosis. I have had stenosis of lumbar spine with degenerative disc disease, foraminal stenosis, radiculopathy etc. my main symptom is that my calf muscles throb painfully after walking even if it's just a few steps. I had a laminotomy to me without fusion but now I was told I need fusion however several surgeons have warned that with my osteoporosis that could be risky. How many people out there have had successful fusion with osteoporosis. I would need three levels fuse. Thanks

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Hi @annie1 - just wanted to let you know that I moved your post to this discussion so that you could talk with others who've had fusion surgery who also have osteoporosis:

- Who has had successful fusion surgery that has osteoporosis? https://connect.mayoclinic.org/discussion/who-has-had-successful-fusion-surgery-that-has-osteoporosis/

Have the surgeons you've seen commented on why they think you are experiencing the calf muscle throbbing when walking? If so, what did they say?

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Profile picture for Lisa Lucier, Moderator @lisalucier

Hi @annie1 - just wanted to let you know that I moved your post to this discussion so that you could talk with others who've had fusion surgery who also have osteoporosis:

- Who has had successful fusion surgery that has osteoporosis? https://connect.mayoclinic.org/discussion/who-has-had-successful-fusion-surgery-that-has-osteoporosis/

Have the surgeons you've seen commented on why they think you are experiencing the calf muscle throbbing when walking? If so, what did they say?

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@lisalucier
Going on for 7 years already but they said it was probably from the stenosis compressing the nerves. Recently one surgeon wanted me to get some kind of vascular test which I have to do. As far as the osteoporosis discussion let me look into that I might have been the one who posted that actually.

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Profile picture for shirleyhibb26 @shirleyhibb26

I have severe osteoporosis, -4.3 on Dexa. I also have degenerative disc disease and arthritis. I’m 62 and had a compression fracture on L1. I just had L1-L5 fusion. This went went well then I started having pain again. I’m now getting RFA from paint and it seems to be working!!

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@shirleyhibb26
I think your pain probably is different than mine because I was told that RFA doesn't work for me cuz I have pain most all in my legs not my back. They said RFA only works for back pain. How long did the fusion last before you had your pain come back?

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