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Thread: Bone density test?? 1 said I need it, 2 said not necessary...

  1. #1
    Join Date
    Jun 2011
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    South Jersey
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    Bone density test?? 1 said I need it, 2 said not necessary...

    I'm confused...(easy to do with all that's on my mind lately!) - - i'm reading on here of many who've had to get a bone density test prior to their surgeries. I had one dr tell me i needed one, 2 said it's not necessary and the last never mentioned it. The one who said i needed one wanted it to be sure my pelvic bones were strong enough to support the fixation using rods from my L1-S1 and into the pelvis. Said if my bones were too weakened (i've had 2 previous surgeries, each requiring bone grafting from each side of pelvis), he wouldn't fuse to the pelvis - instead he'd stop at S1. Two other dr's said it wasn't necessary. I've decided to go with Clements at Cooper but he's one who said it wasn't necessary.

    I'm just wondering what all of you think? Did you have one done? If so, did the results affect the procedure and the need to fuse the spine to the pelvis. I go back on 10/17 and wanted to ask him about this again - but i want to be sure and ask the right questions! Thanks
    1993/1995: PSF w/ Harrington rods T3-L4
    Jan. 24, 2012: ALIF of L4-L5, L5-S1 w/ cage spacer and BMP
    Jan. 31, 2012: PLIF of L1-S1 w/ pelvic anchors
    Scheduled Nov.15, 2012: Fusion T2-S1 w/ pelvic anchors to fix T12 fracture
    http://i31.photobucket.com/albums/c3...ot/myback2.jpg - BEFORE
    http://i31.photobucket.com/albums/c3...CT2342x406.jpg - AFTER
    http://i31.photobucket.com/albums/c3...CT1410x229.jpg - AFTER
    www.jerseyot.blogspot.com

  2. #2
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    6,801
    Hi...

    I think most of the top docs don't request it. I wouldn't worry about it unless you feel like your bones might be in really bad shape. Nonetheless, I think it's a good idea to get a DEXA scan every 5-10 years so that you can start taking some steps toward rebuilding your bone if the results show osteopenia or osteoporosis.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
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  3. #3
    Join Date
    May 2009
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    3,745
    i did not think there was a difference between fusion to sacrum and fusion to sacrum with
    pelvic fixation...thought they were pretty much the same thing...

    i thought, above a certain age, most women need to get a bone density every 5-10 years,
    as Linda said, unless one's bones are so good there is no chance of a problem at all....

    at the time i was considering booking surgery, i was asked to get a recent bone density by my surgeon.
    then i changed my mind about the surgery...for the time being....
    but i do get bone checks done as i have osteopenia...


    jess
    Last edited by jrnyc; 10-09-2011 at 01:54 AM.

  4. #4
    Join Date
    Oct 2008
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    Sunshine Coast, Queensland, Australia
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    My surgeon didn't ask for one however, I wasn't concerned because I'd had one about a year earlier which said my bones were fine. Straight after surgery, my surgeon told my partner my bones were "good."

    Then, about 2 years later, my GP sent me for another bone density scan and my bone density had increased. I put this down to the daily walking I did leading up to surgery and one of the reasons I continue to walk now.

    For anybody concerned about their bone density, I would recommend daily walking if pain permits.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  5. #5
    Join Date
    Jul 2011
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    535
    I'm 43 and was shocked to learn from a bone density test that I have osteopenia (beginning stage of osteoporsis), particularly in my lumbar (there are a couple of discs that measure osteoporosis range). The local surgeon almost hesitated when she ordered the DEXA scan by saying, "hmm... I'm sure you are fine, but let's have you do a bone density scan just to be sure." Thank God that happened because the scan revealed my bones were too soft for the local surgeon's comfort level (she cancelled my surgery). I'd much rather have my surgeon know before the operation my bone density so that optimal correction can be made during surgery. As a result, I met with Dr. Lenke and am scheduled to have surgery with him who explained my bone density issue is within him comfort level of performing surgery. I am currently doing daily injections of Forteo to build new bone leading up to my surgery and will continue with Forteo for the 2-year cycle. My first DEXA was July 2011 by the local surgeon and Dr. Lenke will do another DEXA prior to my surgery next year to see how my body is responding to Forteo.

    I've read how some patients come out of surgery (not having had a bone density test) to find out the surgeon discovered their bones were too soft and were unable to get a better-than-anticipated correction.

    I visit an osteoporosis forum and am learning there are many young women, under the age of 40, who are being diagnosed with osteopenia and osteoporosis. I highly recommend the DEXA scan. I feel it is better to take a test now and know your condition rather than ignore a test and potentially find out later there is an issue. If your surgeon won't order a DEXA, ask your GP or gyno to order the test for you.

    Just my $.02. :-)

    Warmly,
    Doreen
    44 years old at time of surgery, Atlanta GA

    Pre-Surgery Thorasic: 70 degrees, Pre-Surgery Lumbar: 68 degrees, lost 4 inches of height in 2011
    Post-Surgery curves ~10 degrees, regained 4 inches of height

    Posterior T3-sacrum & TLIF surgeries on Nov 28, 2011 with Dr. Lenke, St. Louis
    2 rods, 33 screws, 2 cages, 2 connectors, living a new life I never dreamed of!

    http://thebionicachronicles.blogspot.com/

  6. #6
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    Jun 2011
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    New Jersey
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    I was concerned about this too having been diagnosed with Osteopenia a few years ago but my surgeon isn't concerned with it. He didn't need another bone density test done. He said he will get a better idea once he's in there putting the screws in and he can adjust the hardware he uses a bit if the bones are softer. So I hope it all goes ok. I've been taking lots of calcium supplements and doing weight training but I hope it's enough for my surgery to be successful.
    Nancy

  7. #7
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    Oct 2008
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    Sunshine Coast, Queensland, Australia
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    How long until your surgery Nancy? Weights are good but walking is too, not just for your bones but also for cardiac health. Walking in the open air also lifts your spirits, I believe. Just a suggestion, if you are able to do this.
    Surgery March 3, 2009 at almost 58, now 63.
    Dr. Askin, Brisbane, Australia
    T4-Pelvis, Posterior only
    Osteotomies and Laminectomies
    Was 68 degrees, now 22 and pain free

  8. #8
    Join Date
    Jun 2011
    Location
    South Jersey
    Posts
    133
    Thanks so much everyone for all of your replies! I re-read my xray and CT scan reports and both said that i have the following:
    "osteopenia with multilevel facet disease," "bands of sclerosis in pars articularis on left suggesting possibility of old partially fused spondylolysis," and "multilevel degenerative changes with disc space narrowing worst at L2-3, L3-4, L4-5, L5-S1." It sounds like i do actually have the beginning of what might be osteoporosis with have osteopenia (right??) - i see Dr. Clements again on Monday 10/17 and have a whole new list of questions - and i've added ones regarding a bone density and/or DEXA scan, so thank you again everyone for replying! I do appreciate you input and suggestions!

    Jess: The one dr explained it to me like this...he said the sacrum rests between the two pelvic bones and is actually the "tail end" of the spine. By fusing to the sacrum and stopping short of the pelvis, the dr meant he would STOP at L5-S1 (just AT the sacrum) - the other dr's would fuse the spine TO the pelvis bones with rods/fixators going down into (L/R) pelvis - - like little hockey sticks...fusing down and to the L, and then down and to the R. My translation might not be as good as his but that's how he explained it.

    Well, It's 4am and i've been up for 1 hour...i seem to be doing this alot more frequently nowadays...waking up in pain between 2:30-4am and having to come downstairs and sit on my heat pad instead of tossing and turning in bed. Part of me can't wait to schedule the surgery(ies) and part of me is terrified it won't work. It's in these early morning hours when the house is quiet and everyone (but me!) is asleep when my brain just goes crazy thinking about all the "what if's"
    Last edited by jerseyot; 10-11-2011 at 04:41 AM.
    1993/1995: PSF w/ Harrington rods T3-L4
    Jan. 24, 2012: ALIF of L4-L5, L5-S1 w/ cage spacer and BMP
    Jan. 31, 2012: PLIF of L1-S1 w/ pelvic anchors
    Scheduled Nov.15, 2012: Fusion T2-S1 w/ pelvic anchors to fix T12 fracture
    http://i31.photobucket.com/albums/c3...ot/myback2.jpg - BEFORE
    http://i31.photobucket.com/albums/c3...CT2342x406.jpg - AFTER
    http://i31.photobucket.com/albums/c3...CT1410x229.jpg - AFTER
    www.jerseyot.blogspot.com

  9. #9
    Join Date
    Jul 2011
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    535
    Quote Originally Posted by jerseyot View Post
    Well, It's 4am and i've been up for 1 hour...i seem to be doing this alot more frequently nowadays...waking up in pain between 2:30-4am and having to come downstairs and sit on my heat pad instead of tossing and turning in bed. Part of me can't wait to schedule the surgery(ies) and part of me is terrified it won't work. It's in these early morning hours when the house is quiet and everyone (but me!) is asleep when my brain just goes crazy thinking about all the "what if's"
    This past summer I also had moments of waking up in pain in the middle of the night. My doc gave my hydrocodone which helped and now I only take one occasionally. I keep my heating pad in bed since I need to lay down flat every afternoon (sitting hurts, my ribs press into my pelvis) and then I lay on the heating pad when I go to bed for about 30 min or so. Have you tried using your heating pad in bed which might relieve some tossing/turning?

    I was driving myself crazy with what-if scenarios too, so I stopped and really focus on what positive things can I do today that will benefit my body in preparation for the surgery. It has helped me tremendously to focus on what I am able to do compared to what I'm no longer able to do.

    Warmly,
    Doreen
    44 years old at time of surgery, Atlanta GA

    Pre-Surgery Thorasic: 70 degrees, Pre-Surgery Lumbar: 68 degrees, lost 4 inches of height in 2011
    Post-Surgery curves ~10 degrees, regained 4 inches of height

    Posterior T3-sacrum & TLIF surgeries on Nov 28, 2011 with Dr. Lenke, St. Louis
    2 rods, 33 screws, 2 cages, 2 connectors, living a new life I never dreamed of!

    http://thebionicachronicles.blogspot.com/

  10. #10
    Join Date
    Jun 2011
    Location
    South Jersey
    Posts
    133
    Thanks Doreen for your reply - - i have tried using the heating pad in bed but it just hurts too much to lay flat and when i roll to my side the heating pad doesn't touch my body and then i spend hours trying to rig it so i feel it...it's so frustrating...this morning was even worse...i was downstairs reading emails and watching tv at 3:20am...the pain is just too much some nights that i just can NOT lay there anymore...semi-reclined on heat feels better - - i'm exhausted and with 2 little ones (2-1/2 and 4-1/2) to chase after and entertain, it's just too much some days...today will be one of those "let's all take a rest on the couch days" i think!
    1993/1995: PSF w/ Harrington rods T3-L4
    Jan. 24, 2012: ALIF of L4-L5, L5-S1 w/ cage spacer and BMP
    Jan. 31, 2012: PLIF of L1-S1 w/ pelvic anchors
    Scheduled Nov.15, 2012: Fusion T2-S1 w/ pelvic anchors to fix T12 fracture
    http://i31.photobucket.com/albums/c3...ot/myback2.jpg - BEFORE
    http://i31.photobucket.com/albums/c3...CT2342x406.jpg - AFTER
    http://i31.photobucket.com/albums/c3...CT1410x229.jpg - AFTER
    www.jerseyot.blogspot.com

  11. #11
    Join Date
    Jun 2011
    Location
    New Jersey
    Posts
    16
    Jennifer Im scheduled for next Friday, Oct 21. Ive been trying to stay active at the gym, biking and doing a bit of the elliptical but walking is too painful. That motion of your leg going back behind you is really painful for me. I can only walk for a minute of 2 and then I need to sit.

    Jersey I hear you on the what ifs. When Im busy and going about my day, its not bad to not worry and think and obsess about it. But when Im alone and sitting around feeling sorry for myself, its really tough. I know its easier said then done and I need to do this myself but maybe try journaling in those early morning hours about the what ifs and make them positive. What If I have the surgery and I am pain free. What if I have the surgery and I can play with my children more. Anyway, you get the point. Big hugs to you!

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