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Osteopenia and Spinal Fusion
I have varying opinions from a neurosurgeon and an orthopedic surgeon. Both are recomending spinal fusion from t10 to s1. The recent Dexa scan revealed mild osteopenia in my upper thoracic, and lower lumbar. The neurosurgeon will not do the surgery until I begin a treatment plan for the osteopenia to strengthen the bone structure. The orthopedic doctor said that the dexa scan was normal and that I could still go forward with the surgery and begin treatment for the osteopenia later. The earliest appointment I could get with an endocrinologist to begin a treatment plan is March of next year. Several people have told me that the level of the osteopenia is fairly low and doesn't merit a treatment plan other than increasing my calcium through diet and over the counter supliments.
With the low level of osteopenia, should I worry about the spine fusing to the hardware before I go with the ortho doc and have the surgery in January, or should I wait until I see the endo Dr. in March and postpone the surgery. Is it possible that the neurosurgeon is worried about the rods and hardware fusing because of the osteopenia that is present? The ortho Dr. didn't seem to think it was a big deal and said I could begin treatment later after I see the endo Dr.
Honestly, I think if I was not planning on surgery, an endo Dr. would only have me increase my calcium and then get retested in a year. How real is the risk of the fusion surgery failing with mild osteopenia?
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Personally, I would NEVER let an ortho surgeon perform any surgery on my back! Reread your post —- the ortho sounds very flippant whereas the neuro is cautious. The spine is like a telephone line for the nerves of your body. I urge you to be very careful. See the endocrinologist. Weigh in all the data & then decide. I had a three level c-spine fusion by a wonderful neuro and so did my husband. I have osteopenia. The surgeons were cautious for that reason. Good luck & Good recovery!
Thank you for your comment to my question. My husband also had fusion from C1-C3 and had a neurosurgeon perform it. He was not interested in doing the surgery on me because it would involve reconstructive spine surgery to correct the scoliosis. That type of surgery is mostly performed by orthopedic surgeons.
I have placed a call to the neurosurgeons office to review the dexascan again.
I am anxious to hear back from him to either scare me to death if I go forward with surgery in January with the ortho doc, or wait until March only to be told, no problem with having the surgery now and just get another dexascan in a year, meanwhile I am two more months out to begin rehabilitation. The dexascan catagorized the osteopenia a 1.25, within normal range for bone density.
I just had L4-5 FF fusion with osteoporosis/osteopenia. The doc said my bones were spongier than she would prefer once she got in there to see the bone. I had been taking Prolia and had improved but then surgeon wanted me to take a bone building med. she didn’t know not to follow Prolia with Tymlos. . I took tymlos for 4 months but couldn’t tolerate the nausea and dizziness. Next up is Evenity. 🤞🤞. So far I’m doing well with fusion. Initially I had to wear a brace 24/7 for 6 wks. Just started PT after 3 months wearing a brace when up and around.
I had spinal fusion & then a hip replacement 3 months
later & the physical therapy afterwards made all the difference. I take over the counter calcium & a once a week prescription drug , Alendronate, & try to have milk with cereal at least 5 days a week............& hope for the best.
Look for other Calcium sources also 🙂
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