Mariaa,

I just wanted to say I can relate to your situation as far as the osteopenia goes. 2 years ago I had a lumbar t-score of -4.4 (yes, you read right). I was 47 at the time. I would never have been tested, and therefore never even known about it, had Dr. Fenk-Mayer not required that I have the DEXA test when I was communicating with her about possibly going to Germany for a 3-level ADR (L3 - S1). Even Dr. Bertagnoli would not consider ADR augmented with vertebroplasty with that t-score. My endocrinologist put me on Forteo and 2 years later (my last DEXA was in March) my t-score has improved to a -2.2. Amazing, huh? I must say that the improvement can partly be explained by the fact after I had fusion done at L5-S1 a year ago I began weight-bearing again, although limited to one or two hours a day (I had literally been crawling on /my hands and knees.) Also, I was diagnosed with secondary osteoporosis, due to a vitamin D deficiency. Along with the Forteo, my treatment has included 50,000 I.U.'s of vitamin D per week. To this point, I have been continuing with the Forteo hoping that I can actually get under a -1.5 (Dr. Regan's criteria) for a possible 2-level ADR here in the U.S. Unfortunately, though, my insurance is Medicare (from disability) and now I am reading on the forum that the hospital (Cedars Sinai) where Regan does the surgery is not accepting Medicare patients for ADR. And of course, it also looks like the CMS is about to issue a national non-coverage determination for the Charite', including those under 65 on disability. From some posts I've been reading on this forum, the out-of-pocket cost of a 2-level ADR in the U.S. (without insurance coverage) would actually be more than having it done in Germany.

I think your husband makes a good point in terms of going to Germany for the surgery. I say this because I read another post (sorry, can't remember the name) where someone was saying they tested at a -1.5 and Dr. Bertagnoli did the ADR. When they opened him/her up, Dr. B found the vertebrae to be much weaker than the -1.5 would indicate (like "butter", I believe were the words used to describe the bone) and ended up needing to use vertebroplasty anyways. So I'm wondering if for someone like me, who is already starting out with osteoporosis/ostopenia issues, it's too big a risk (even if I could get my t-score to -1.5) to have it done here, where they do not have access to the appropriate bone cement that they do in Germany and therefore cannot do vertebroplasty even if necessary.