I'm so sorry you've been dealing with this for so long. Since your spine surgeon and endocrinologist are recommending different treatments, maybe ask them to discuss your case with each other. Your surgeon may be thinking about optimizing bone quality for spinal surgery and your endocrinologist may be focused on long-term osteoporosis treatment. It would be helpful to understand why each is recommending their approach in your specific situation. Given your history of lung cancer, bypass surgery, and ongoing severe pain, be sure your persistent pain has been thoroughly evaluated before moving forward. Wishing you the very best.