Building bone before massive spinal surgery

margaretisabel,
There are two excellent medications you might consider. One is Evenity. It builds the heaviest bone more quickly than the other medications. Original Medicare part b pays for 80% If you have a secondary it will pay the remaining 20%. It is covered by Medicare because it has to be given in clinic. It is two injections every month.
You might consider Evenity because it adds the most bone in the first three months. You seem not to want to wait for the surgery and it would be the quickest path.
Without telling any stories, you shouldn't take Evenity if you have cardiac issues.
The second medication is Forteo, which I'm partial to. It builds a more careful bone, more slowly. But it focuses on the vertebrae and would help to integrate the hardware from your surgery into the bone.
I'm sure I would choose Forteo, or try to get Evenity for 3 months and then switch to Forteo.
I've never taken Evenity and think that it causes joint aches for most patients. I'm on Forteo and have every good thing to say about the drug. I don't know what your insurance covers, but I guess you have until Dec 7 to find the best coverage. If you are low income you might call RX Advocates. I think they can tell you on the phone if you would qualify. https://therxadvocates.com/
Your endocrinologist may have the best advice but you could ask about these two drugs.
I'm assuming your surgery will be fusion, but wonder if you have looked a artificial discs.
Mostly I'm very excited for you with this surgery. It is going to be a different world.

I too was denied surgery because my bones were weak. They did not think it would hold the hardware. Thus cause more damage. I took forteo going on 18 months. Some improvement I would suggest trying forteo or tymlosl as I was told many athletes use it to build and heal bone. There are some side effects but when you think about enduring for just 12 to 18 months it's doable. I would find the very best doctors and then get second opinions for sure before getting surgery. So grateful I did.
You're not alone. This is a wonderful site for support and self-education that we don't get always from our doctors.

Thank you, I appreciate your help. Do you mean you are so grateful you took Forteo, or had the surgery? I’m not sure how bad my osteoporosis is comparatively, just that I need the meds to build bone for surgery. Do you recall what your bone density numbers were before and after Forteo for a year?
I’m wondering what side effects are most common. What were Forteo side effects for you? I’m concerned about headaches because I’ve had intractable migraine all my life, multiple times an month, and there’s almost no med that helps except one that I take rarely, to abort, not as preventative, because it’s completely unaffordable. . . Medicare covers a small portion. If Forteo tips the scale into more migraines, I literally will not survive. Thank you again.

@gently
Hello,
Thank you for clear and supportive thoughts. I will ask about the idea of Evenity first, then moving to Forteo. I do not have cardiac issues, but I take a migraine med daily for hoped-for prevention that increases risk for heart attack and stroke. I’ve been taking it for over 20 years with no issues. I still get horrendous break through migraine about once a month and have another med for those to abort, when I can afford it. So headaches listed as a side effect is scary.
Have you had spinal surgery?
The concern from the surgeon is my spine has worsened drastically since the fracture healed and it will continue yo worsen. At the same time, how can I face multiple surgeries to keep repairing the failures to hold the hardware? 🙏

@margaretisabel
Is Emgality a possibility for your migraines? I know a person who gets it free via Lily Cares.

@normahorn yes thank you, Emgality did not help my migraines. I believe the free offer is to those not on Medicare. Thank you. 💚

@redlo, how long were you on Forteo before surgery?

@margaretisabel

I am one of the unfortunates s that did not get any gain after a year on forteo but, After a consultant with McCormick and my endocrinologist and looking at my blood work which was done before and every 3 months after shows: I have great gains with my P1np. From 19 to 378.and the CTX also in proportion. McCormick and my endocrinologist want me to finish out my 18 months and take another dexa. They both assured me it was working by looking at my blood work and that possibly dexa machine had been recalibrate?I am holding on to that with much prayer. I will admit I was devastated but I feel stronger. I'm able to do more and there is a difference between density and bone strength I was told.
So important to get a second opinions. Three doctors wanted to operate right away I hate to think what would have happened if they. Please put the time to seek the very best when it comes to your spine, even if it means traveling 6 hours away. I found a specialist and he was able to do a laminectomy to relieve my pain and help the function of my leg return.Putting a back fusion on hold until my bones are stronger.

My husband is 75 and has severe osteoporosis with 14 fractured vertebrae all on the front side causing hyper kyphosis. His spinal fusion is scheduled for January 14th. He has been on Forteo over 2 months now. We have Medicare Prescription Part D. They are paying but we still have about $500 copay and it’s hard to get. I looked up several other options in the insurance and the ones available to us to do not cover it at all. A year supply is over $40,000. So for now we are sticking with the one we have. His fusion will be from C2 to T12 so it’s extensive. But his chin touches his chest now and he has trouble swallowing and shortness of breath from the kyphosis. He’s kinda”damned if you do and damned if you don’t “. Hope you get some help and relief.