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Old 12-04-2006, 03:48 PM
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Join Date: Sep 2006
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Default Bone Density readings in already fused segments?

Greetings from Nijmegen, Holland! I'm about 1/2 way through an amazing trip with some quite incredible surgeries and happenings along the way. I'll try to post more later. I just want to throw some info out there because I found it quite interesting.

One of my clients has a long scoliosis fusion from high thoracic to mid lumbar regions. Prior to surgery, a bone density test was done and my heart sank whan I saw the readings and average t-score that indicated severe osteoporosis.

Further discussions with the surgeons revealed that while her t-score indicates severe osteoporosis, she may not be osteoporotic at all. She had harrington rods that spanned the fused segments for 15 years. In the 2 years since the rods were removed, she's been substantially disabled, so her activity levels have been extremely low and she's spent much of the time bedridden.

In the 15 years following the fusion, the spine was substantially off-loaded by the harrington rods. It is considered that she is not really osteoporotic, she has localized bone density issues where the harrington rods relieved the loading... this reduced bone density is a natural and expected side-effect of her configuration. Fortunately it did not represent a challenge for the surgery... I hope to post details of this major recontstruction later.

1997 MVA
2000 L4-5 Microdiscectomy/laminotomy
2001 L5-S1 Micro-d/lami
2002 L4-S1 Charite' ADR - SUCCESS!
2009 C3-C4, C5-C6-C7, T1-T2 ProDisc-C Nova
Summer 2009, more bad thoracic discs!
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Old 12-05-2006, 04:52 AM
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Join Date: Oct 2006
Location: arizona
Posts: 256

You raise an important issue about interpreting spinal bone density readings and the need to put them in the context of spinal issues. Apparently, scoliosis can lead to falsely decreased readings while vertebral fractures, osteoarthritis (osteophytes?) and aortic calcification can lead to falsely increased readings.
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Old 12-06-2006, 05:39 PM
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Join Date: Sep 2006
Posts: 2,405
Default Bmd

This is really interesting. I'm so glad to hear that this issue wasn't an obstacle for this person and the surgery~ my best to her with recovery!

I would like to say that I have confidence in the BMD testing in the U.S. tho I guess because I happen to have spine osteopenia and hip osteoporosis I worry about ADR w/o option of vertebroplasty.

Please do keep us updated ~ what incredible things you are able to learn and take part in!!!!
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Old 12-08-2006, 05:52 AM
Join Date: Oct 2006
Location: Colorado
Posts: 67

Wow, great info Mark! My mom has the same fusion for scoliosis. I wonder if they considered this when they did her bone-density testing, though she wasn't considering surgery. If I may ask, what was the reasoning for taking out the Harrington rods? They offered this to Mom, but she couldn't see the benefit. Just curious. Have a great trip!
Herniated disc lifting at age 19
Laminectomy at L4-5 in 1998, repeat in 2001 same level
13 docs, 9 PT's, 8 Epidurals, 3 trigger point inj, 1 Facet Block, 1 Acupuncturist, 3 Chiros and 1 child later, had L4-5 ProDisc placed 9-19-06 by Dr. Janssen in Denver, CO. Facet rhizo March, 2007, November 2007, January 2009
Had healthy baby boy #2 in Dec 2008 with use of some meds during pregnancy and nursing.
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