Bone Density Scans....

[Tatonka_usn]

Was curious if anyone could recommend the most effective bone-density scan for someone considering ADR? I searched in here and found the thread which provide all the different types of scans (Bones Density Resources), but it was geared principally toward osteopurosis (sp?), and not necessarily surgery. Is there one that surgeons tend to prefer, or that is more accurate? I've heard DEXA mentioned most often, but I don't think the radiology clinic near me (that's on my insurance plan) does that version. Should I look elsewhere, or consider paying out of pocket? Just curious, as I'm rapidly reaching the end of my rope due to increasing pain

[annapurna]

I can't answer your specific question but would make the point to make sure the scan is done to include some of your spine. I had my hip and lower lumbar spine checked and had very slightly different levels (an expected result). If you're borderline, it could be critical to check the areas where the ADR is going. Hopefully, you'll have no problems at all so it will not matter what gets checked but it's probably worth hedging your bet.

[Jstuckey]

They check for osteoporosis to make sure you are safe to receive an ADR, since there is bone involved in the surgical process. My surgeon said anything better than -1.5 if I remember correctly, was ruled OK for an ADR, but that may be surgeon specific. I had a DEXA but I wouldn't think it would matter. It's an acceptable range they are looking for.

[Jstuckey]

Here's my report if it helps any:

EXAM DESCRIPTION: DEXA BONE MINERAL DENSITY STUDY
INDICATION: Low back pain with radiculitis.
COMPARISON: None.
DISCUSSION: Bone Mineral Density (BMD) evaluation of the lumbar spine and
hip was performed using DEXA technique and compared to normal and agematched
controls.
FRAX evaluation of patient specific data to include bone mineral density,
body mass index, personal and family fracture history, use of tobacco,
glucocorticoids, alcohol, etc. Lumbar spine L1 through L3 BMD is 1.112
with a T score of -0.5. Left femoral neck BMD is 1.112 with a T score of
0.5. The major osteoporotic risk is 2.0% and hip fracture risk is 0.0%.
Both values are below the levels for which the use of bone building agents
is recommended by the National Osteoporosis Foundation.

IMPRESSION: Normal bone mineral density.

[Tatonka_usn]

Originally Posted by annapurna

Hopefully, you'll have no problems at all so it will not matter what gets checked but it's probably worth hedging your bet.

Originally Posted by Jstuckey

They check for osteoporosis to make sure you are safe to receive an ADR, since there is bone involved in the surgical process. My surgeon said anything better than -1.5 if I remember correctly, was ruled OK for an ADR, but that may be surgeon specific. I had a DEXA but I wouldn't think it would matter. It's an acceptable range they are looking for.

Thanks for the feedback, folks! Kinda figured this was just a function of dotting the I's and crossing the T's, but when the time comes I want to be able to provide EVERYTHING necessary to a potential surgeon in one packet, and get the word back that all is good to go. Not being familiar with this particular test, and knowing my luck, I just wanted to avoid wasting time and money ;-)

[laid up doc]

if you're a man and haven't been on long term steroids or have any other metabolic/endocrine issues... your bone density shouldn't be an issue.

i had one this year b/c of a 2nd foot stress fracture w/o clear reason - it was fine. i wasn't asked about it by any of the surgeons i saw, since i'm a woman of childbearing age. i brought up the stress fx thing and they still didn't seem fazed...

[Tatonka_usn]

Originally Posted by laid up doc

if you're a man and haven't been on long term steroids or have any other metabolic/endocrine issues... your bone density shouldn't be an issue.

That was pretty much my thought as well, but one Ortho Surgeon in Northern Va I consulted with last year actually asked me to get one done. Given the fact that he was only offering me an ALIF, I pretty much wrote it off at the time. Now that I'm giving more and more thought to heading overseas (or at least going through the work-up process), I happened to recall that it had been requested in the past. My HX doesn't honestly warrant it but, again, I'd rather be safe than sorry (knowing my less-than-stellar medical luck).....

[annapurna]

Don't bet on it; get the test done. I'm male and was diagnosed with severe osteopenia bordering on osteoporosis at 38.

[Harrison]

Some of you may have seen this old topic, but it is packed with useful information:

Spine Osteoporosis

Please note it is 3 pages, it's now a sticky topic in Arthroplasty Central. Also check out the actual DEXA scan reports from a patient in this community.

[jss]

Originally Posted by annapurna

... I'm male and was diagnosed with severe osteopenia bordering on osteoporosis at 38.

Jim,

As this is unusual for men, I am very curious. If you don't mind me asking, how are you treating your osteopenia? Drugs? Weight lifting? Running? Some combination of all of that? Something else?

Thanks, Jeff