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Spinal Fusion and Osteopenia
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Spinal Fusion and Osteopenia

I am a 60 year old woman facing spinal fusion surgery.  Over the last two weeks an orthopedic surgeon and a neurosurgeon have both recommended L4-L5 fusion with instrumentation for my Grade I spondylolisthesis (9mm) and severe foraminal stenosis at L4 on L5 with mild impingement of the left L4 nerve with almost complete loss of disc and moderate foraminal stenosis with mild neural impingement on the left at the L5-S1 level.  A bone density scan conducted nine months ago showed AP spine (L1-L4) results of BMD (g/cm2) 0.790, T-Score of -2.3, and Z-Score of -0.9.  

I am writing because I am confused since the neurosurgeon said that he would use instrumentation on both sides of my spine to support the fusion since my bone density numbers showed that I was very close to osteoporosis and therefore needed the extra support.  The orthopedic surgeon said that extra support wasn't necessary and that he would perform the surgery in the usual way with support on one side of my spine.  So which is better?

I am also considering addressing my bone density issues by having a Reclast IV infusion but I am wondering if it is okay to do that just prior to having surgery or should I wait until after surgery or should I get the infusion and then wait a while for the surgery??  I mentioned to the orthopedic surgeon that maybe I should have the infusion and wait a year and he said that Reclast won't replace bone, just halt bone loss, so it didn't matter but when I read the information about it it said that after 36 months that Lumbar BMD increased 6.3% in the clinical trial.  

Thanks!
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Have you seen a chart of your bloodwork recently. The vitamin D defiency numbers might be helpful to check how close to osteoporosis you are. Many friends have had fusions and it seems to be about a 50/50 shot at the success rate. I'm not trying to scare you, but rather just telling what I've been seeing. Best wishes!
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