Got another call from RO. SBRT to L5 recommended. Probably 2 sessions but he'll know for sure once he gets me on the table for targeting.

As far as the other "Diffuse heterogeneous marrow signal" I was concerned with; he feels it is most likely age-related sclerotic degeneration and not that much different from a lumbar MRI I had 3 years ago. Additionally, he said that if it was metastatic disease, he would expect my ALP to be 3 or 4 times what it is.

So... scheduling will call tomorrow to set up SBRT targeting and treatment dates. Hope it works and I can sleep through the night for a change.