Biophosphanates and ADR or fusion

[sahuaro]

Maria: Thank you for letting me know what happened when you took a "vacation"--it confirms my PCP's experience. I am also anxious to hear your reply to ans' question about whether you were taking another med which could have contributed to the significant decrease in DEXA scores.

[ans]

Here's something that may be of consideration bone experts. My DEXA scan of my hip(s?) was -2.5 to -2.7. However, my CT bone density scan of T12, L1, and L2 was averaged to be - 1.0.

So my internist, who's pretty smart (but I have questions on this) said that the CT is a more reliable source and a new CT of the hip is unwarranted. I said, but what if there is some higher bone density from DDD at L2 and I was dismissed.

So I don't know but maybe a CT scan for confirmation? If so, of what? Hip as proxy or such levels?

Do we have a resident rheumatologist, bone biologist, and radiologist on-board?

Good luck; sorry this happened.

ans

[sahuaro]

I just did a brief google search and it appears that your internist is correct when he says that the CT scan is more accurate and is less prone to distortion by DDD and scoliosis because it only looks at trabecular bone. Did you also have DEXA of the spine and if so, was there a significant difference between the DEXA and CT scores?
My DEXA scores indicate no problem with the spine but osteopenia in the hip, so I am showing a similar pattern. I do wonder whether there might be some distortion elevating the DEXA spine scores but I really think it's just a hip issue.

BTW, in my brief search, I found a research article which concluded by recommending cervical spine CT bone density evaluation of endplates prior to implantation of hardware (fusion or ADR)....hmm...

[ans]

Thanks B, the 'ol researcher genes kick in. I wonder w/DDD if the endplate trabecular network is so distorted as the bone (in my MRI) looks hyperdense. One surgeon said that this is good for ADR/surgery.

I would feel better w/a bone density CT of the hip but insurance would fight.

Good luck in your tough quest.

I can't get a grip on the Mt. Lemmon snow forecast/conditions. Lots of lightening?

Be well. - ans

[JeffreyD]

Regarding Dexa scans, it is very important that subsequent scans be made using the same equipment, and the same operator, if possible, as your first scan.

FYI.... I have been on Fosamax for almost five years now following my first ADR (3-level lumbar) surgery. During this surgery my bones were reported to be very soft. Following surgery, I had a Dexa scan - results were osteopenia (-2.1 lumbar). Results have improved to within normal range as of last November. Results were -1.7 after the first year, so for me, Fosamax works.
Incidentally, I had a 2-level cervical ADR in 2007 with no subsidence or post-surgical structural events of any kind.

My bone specialist explained to me that the question of "brittle bones" as a result of Fosamax use is impossible. Biophosphates, he said, can not change the way your body builds bone; it only changes (slows down) the natural reabsorption rate of bone within one's body.

-Jeff

[sahuaro]

Jeff:
Thanks for the info--as my PCP indicated, the literature on biophosphanates is confusing and often contradictory. You certainly had a dramatic improvement with the Fossamax, which is terrific. Were you able to have DEXA scans with the ADR's and if so, did they have to make any adjustments? I'm asking because when I went for my scan, they asked if I had any metal in my body and when I indicated that I had a cervical ADR, the response was that the scan wouldn't be near there so it was a non-issue. I am kicking myself now for missing an opportunity to glean some information about this...

From your and Maria's experience, I guess I am leaning towards remaining on the Actonel...

[ans]

Glad Fosomax helped you! I thought this Rx kept bone density at a stable level unlike Forteo which I heard "grew" bone.