Anyone had spine surgery who has osteopenia or osteoporosis?

@lisalucier
Actually that was me that started that discussion a month or so ago. I'm going to put another question out to everyone. I think it's probably necessary for a surgeon to want you to have a dexa scan and CT scan if you have osteoporosis before fusion surgery? I read in a NIH research article that are in HU. That stands for hounds field units I think and is much more precise than the dexa scan. I already had bad luck just with a laminotomy and I think it's because of my osteoporosis. I got a pars fracture from the surgery. I don't want to risk anymore things going wrong because of my osteoporosis.

@annie1
Hi
I had fusion of L1-L5 on October 13, 2025 and the pain was back at the end of January 2026. Bad pain but yes only in my back, does not go down my legs at all. I have had the 2 tests either numbing agents and now in 2 weeks I’ll be able to do the RFA. I’m hopeful it will take the pain away!!

Hi @annie1.
I had a long fusion in Oct. for scoliosis correction. While going through the hoops to find out if I was a candidate they discovered the osteoporosis. I was started on Forteo and took it for 6 weeks prior to and paused for 6 weeks after. The HU score is what the surgeon went by to move forward with the surgery. I had chronic pain for years and had ran out of solutions. The surgery is rough and recovery is rougher, but I have no pain in my back! I have some nerve sensitivity but it is nothing comparatively. I’m continuing to take the Forteo and have had no side effects. I don’t go back to the endocrinologist until October and will likely have all the scans at that point. There’s a lot of information to take in. This forum is a wealth of knowledge. Wishing you the best.

@annie1 I am in the same boat you're in with the stenosis and other degenerative issues, but I also have severe osteoporosis. Fusion at from L4 to S1 apparently is imperative in my case -- I was told by a neurosurgeon yesterday that if I don't have the surgery, I will eventually lose my ability to walk. The surgeon I saw has a track record of dealing with patients with "weakened bones" and uses a bonding cement in the fusions as well as the usual pins and screws. Still, there is no guarantee of success. But in my case, because of a badly slipped disc and an unstable spine (among other issues), it seems my only option. I think you would benefit from talking to a surgeon who has experience with osteoporotic patients. Wishing you the best!

@bayhorse
Hello well thank you but they all say they know what they're doing with osteoporitic patients none of them are going to admit that it puts me at high risk. At least here in New York. They just say they can do it as long as I'm on the bone building medication and that they're going to use the cement augmented screws. You can't get an answer about how many patients they have had failures with. I had a failure with this one surgeon not with fusion but with just a laminotomy which caused a Pas fracture and made my come back. He said he would do a fusion now with the augmented screws but it took him 2 years to admit that he had caused the Pars fracture. I am struggling because I am in pain but I don't know if I should trust him. I know there's plenty of other surgeons and good ones out there. I'm going to get another dexa scan which he doesn't even require before surgery.

@annie1 You have my sympathy. And while I certainly couldn't tell you what to do, it does sound as if you need to go for a second opinion, and maybe a third and a fourth, just to meet some other surgeons and get a feel for them and see if they can answer questions that this guy hasn't answered. You are entitled to a choice of doctor, and certainly you are entitled to one you trust. Is there someone in your area who has a reputation for being the doc who fixes others' mistakes? Or who is the go-to guy for osteoporotic patients? Can any tell you how many osteoporotic patients they've fused? I am having the same trouble finding the "right" surgeon and getting answers -- it is a very laborious process! And I know it's hard to persist because of the pain. But I figure we all should go into surgery feeling good about the guys who are going to cut us up and, hopefully, put us back together in a better fashion!

I am in Texas, which is no help to you. But my family wants me to come back East for surgery and suggests the Hospital for Special Surgery in New York. Perhaps that would be a resource for you. Meantime, fingers crossed for both of us.