Building bone before massive spinal surgery

@ibarrow It has now been almost nine months since my back surgery, and I am doing well. Surgery does not make you the person you were before your back problems developed, but I have an active life largely without pain. There are some yoga poses that I will never do again due to the loss of flexibility, but my goal was to retain the best quality life possible. I succeeded. All of the osteoporosis drugs have the potential to cause side effects, and these can vary widely. Some people seem to take these drugs without any problems. Others have debilitating side effects. There seems to be no certain way of predicting how an individual will fare. For me, high blood pressure was the critical problem that I had with Evenity, but I was able to manage that with medication from my primary care doctor. I quit Evenity after six months and several weeks before my surgery. Now, about ten months later, my blood pressure is normal--managed with a very low dose of BP medication. I had reviews from four back surgeons at four major medical institutions before my operation, and each recommended a different procedure. The one thing about which they all agreed was the necessity for being on Evenity for at least six months prior to surgery. Forteo seems to be a good medication, but it requires daily injections. I preferred to get the monthly injections with Evenity. So, this is probably a decision that you will have to make regarding what you feel is best for you. I will be on Prolia for the remainder of my life to "lock in" the benefits of taking Evenity. I have had one shot of this drug and no issues from that shot. I actually was on Prolia for a while prior to developing serious back problems and had no adverse effects from the medication during that period. I do not know if this helps you in your decision making, but the best advice that I can give you going forward is get as many opinions as you can about the various osteoporosis drugs and about your prospective surgery--so that you can make the most informed decision possible.

I got my first Prolia injection about four and half months after surgery. I was driving by then and getting around pretty well. My surgery did involve a spinal fusion. It was pretty major, but my surgeon was darned impressed with how well I did. I was able to get myself out of bed and walk around the hospital very quickly. There were two problems, though, I got a nasty UTI exacerbated by the catheter, and I told my surgeon that there is a new catheter invented by the University of Pennsylvania that minimizes these infections. I have a one-year check-up in December, and I think that I will remind him that the hospital needs to get those catheters. A second problem was the food in the hospital. You have to eat a lot of protein after these surgeries, and I was given Ensure with every meal, which I cannot stand. I made them bring me a dish a plain yogurt with every meal, but you might ask your support team to provide you with some decent high protein food. It is a rare hospital that has good food.

These are difficult surgeries, but I needed to have this done. My spine was so out-of whack from unevenly compressed discs that I had two spontaneous spinal fractures several months before the surgery. There was no trauma. I did not fall, and my bone density was not that bad. It was rather like the column in a building failing because it just could not bear the load. So, while I never want to have another surgery like this again, it had to be done. I am now doing well. I walk two miles every other day, I am gardening. and I am largely pain free. As mentioned, I have lost some flexibility, and I seem to pull muscles more easily than I used to, but otherwise life is good. I hope this helps.

P..S: Get yourself in the best physical condition possible before the operation.

@nliebrecht @margaretisabel
Hello:
I apologize for the empty comment I sent earlier. This is my first time on this site. I have read all of your posts carefully, and I greatly appreciate the information you have shared.
I am a 71 year old woman with severe osteoporosis in the femoral neck (T Score -3-3) and a healed L1 compression fracture that was recently discovered on an MRI. I may need a multi-level lumbar spinal fusion within the next 9-12 months. I am just starting to research surgeons and have my first appointment in October. In the meantime, I have been on a drug holiday from Alendronate for the past two years, and I need to start a medication ASAP because my recent DEXA scan showed that my T Scores are dropping. My rheumatologist recommended either Evenity or Forteo, and has left the decision to me. I understand that both of you took Evenity for 6 months prior to surgery. I would like to know when your surgery occurred relative to your last Evenity injection, what you took after Evenity to lock in the gains, and whether you took the follow-up medication before or after surgery? Of course, I would also like to know if your surgery was successful and if you achieved a solid fusion of any vertebrae that were fused. I sure hope you are both doing well!
Thank you in advance for any thoughts!