Hi my doc has suggested I go on Zolendronic infusion and said my spine has got significantly worse I don’t understand the t score system mine says
Lumber spine -3.4 z score -1.6
Neck -2.0 z -0.1
Does anyone know if this is in the good or bad catagory
Then risk fracture 10.9%
Hope somebody can help me understand.
Thanks
T-scores compare your bone density to an average 30 year old, estimating how much has been lost since peak bone density at that age. Z-scores compare to average for age. Negative numbers show bone loss, the nearer to 0, the less has been lost. You spine t-score is well into the osteoporosis range, but your neck of femur (part of the hip) is osteopenia. Both z-scores are within the normal range for age (anything better than -2.0). That's a huge difference between your spine and femoral neck t-scores - do you have arthritis in your hip, that might make your bone density appear to be better than it is, or curvature of the spine which might make your spine score appear worse? What were your spine and femoral neck scores from your previous scan? If your spine has got significantly worse, but your femoral neck hasn't, that does suggest an error may have been made, and is certainly something I would want to discuss. Your fracture risk means you have a 10.9% chance of fracturing in the next 10 years, or put another way, about an 89% chance of not fracturing in that time. Have you had any fragility fractures?
Hi thanks for the reply I have mild arthritis in my hip no curvature of spine I have not had any fractures the only thing I can find about my last dexa scan is the spine which was done 2 years ago and was -2.8 it’s all very confusing.
Unless you're on a medication or have a health condition that would lead to rapid bone loss in your spine but not your hip, it's very unlikely that you would have gone from -2.8 to -3.4 in 2 years. Are you in the UK? If so, would you consider having a private REMS scan and consultation for a second opinion?
Hi yes I am in the uk not really considered anything else my doc said about going on Zolendronic acid infusion I tried alendronic acid for two years about 4 years ago but wasn’t keen taking it in tablet form standing up etc. I have to ring doc next week to see about getting a referral not keen on taking anything but my mum was really bad with her back and ended up with a dowergers hump.
Has your GP run blood tests to check for underlying causes, including hyperparathyroidism ( not the same as thyroid)?
No not had any blood tests done she might suggest that when in ring up on Tuesday.
When first diagnosed you should have had blood tests for Vitamin D, calcium and parathyroid (in the same blood draw), thyroid, coeliac and a full blood count. If they've never been done, I would ask for them now.
Thanks for all the advice I have a telephone appointment with my GP on Tuesday so will ask about blood test.
Hi I asked my GP last week for this and she said they dont do that test only thyroid????
Unfortunately many GPs don't realise that you can have normal calcium and still have hyperparathyroidism (it's called normocalcaemic hyperparathyroidism), so if they do a vitamin D and calcium test and the calcium comes back normal, they refuse to do a parathyroid test. Hyperparathyroidism is considered to be relatively common, particularly among older women, and is a known cause of osteoporosis, so it's beyond me why this particular blood test isn't run automatically when osteoporosis is diagnosed.
Wish everyone with osteoporosis got hyperparathyroidism ruled out as its know to cause osteoporosis and once the faulty gland is removed bone density in most cases improves Also I thought bisphosphanates were only appropriate if the Frax score is 20%?
The FRAX score is definitely what should be used as a basis for recommending medication. However, how high the score needs to be depends on age. As you can see from the chart on this page, if you're 50, medication is recommended (Intervention Threshold line) with well below 10% risk of fracture, but by age 70 it's nearer 20%: nogg.org.uk/full-guideline/...
I am just as bad-2.5 lumbar spine 4.1 and bmd at femoral neck 0.593 vfh superior end-plate deformity at t12 with a mild to moderate wedge compression fracture, am I ok to still do weight training.
Hi,
My bone density is in a terrible state and rheumatologists have discharged me 6 times. Following smashing 7 bones in much ankle, including the 3 main ankle bones, a trimellior fracture after stepping over a puppy gate inly. A specialist nurse after arranged a new bone scan. I was started on Alendronic acid fir a few weeks but given romosozumab, Evenity injections. I do this for a year then probably the infusions. Have you checked Google as I can't remember the score system. See how you go for the infusions once a year for 3 years. My sister is on her last and hopefully it will help you. Good luck.
Hi, when I was first diagnosed with Osteoporosis the scan showed very similar decreases in my bone density to your own.
In my own experience the scan results can be a bit variable, it’s not an exact science, but it does show the trends in what is happening to your bones.
My own rapid bone loss has not been able to be explained despite the usual blood tests and more investigations.
I now have had 15 spinal and 2 rib fractures.
My advice would be if you can find a suitable treatment for yourself take it and stay on it.
Do everything you possibly can to avoid having fractures x
Will do thanks
I am on the annual treatment and I have gone from excruciating pain to bearable pain. The drugs must do something. I am due my second perfusion next week. Yes there are some side effects but they settled and the pain reduced dramatically. I am 78.
Which treatment are you having? and what were the side affects
Sorry for the delay. I am getting my second infusion of Zolédronique Acid (I live in France). My spinal pain has been helped but I still get pain. There is no magic for me. I have a broken vertebrae with 5 to 7 crushed vertebrae with a trapped nerve. I have gone from Oxytocin to paracetamol so it must have some effect. My side effects were frontal rib pain BUT I dont know if the treatment caused this as I lifted my disabled daughter for 15 years from bed to wheelchair to car and packing chair to fit in car without any help on how to lift correctly and I damaged my sternum so the pain could well be that. A TENS machine helps with the pain and at night I use a heated pad on my spine. My spine is curving due to the fracture. I am 78 so it took me quite some time to get treatment being given Prolia for a year and then stopped with no support. That has known risks for fractures. I changed Rheumatologist (easy to do in France) and was put on Acid Zoléndronique thankfully and she has suggested I stay on over the normal 3 years if it improves my situation. I am late getting this infusion as we had the flu. Do read the notes on drinking a lot of water before and after treatment and take paracetamol on the day. The paracetamol came on the same prescription. All in all I have improved. I would recommend it but do ask any questions you might have if possible.
Did you have the zoledrolic acid infusion? I have recently had it and got ibs and general stomach issues after it. Did you have stomach issues with it?
Do you think an Alendronic acid infusion can actually help pain of fracture sites?
It has helped me. It takes time but if you keep a diary on pain etc levels you will see if you get any improvement. I definitely have seen improvement.
That’s hopeful - thanks for replying
I don’t have access to the score system but I think it should give two different scores, one for overall risk and one for hip fracture, but I am going by my own experience with this. If it’s got worse, that is why he wants yo to have the zoledronic infusions.
Thanks
I went from -2.5z to -3.6z in spine, in just under 3 years. Rheumatologist didn’t seem to have time to discuss this exaggerated difference. All he said is: your osteoporosis is severe therefore you need the treatment.
I had the same tbh he told me severe osteoporosis referred me to a nurse now on Teriparatide injection it is so annoying they don't explain things
Per AI....The lumbar spine is composed of trabecular bone which tends to lose density faster than cortical bone (found in the hip)
I have had severe osteoporosis for years in my spine, and just mild osteopenia in my hips .
I recently finished a year of monthly injections with Evenity, which improved my lumbar spine T-score from -4.3 to -3.00...Evenity is especially recommended for low density in the spine.
Thanks for info it’s all mind boggling
Yes it is!
Hi I also have a -4 score in my spine and was recommended to take the eventy injection. I read up on it and wasn't sure of the side effects so declined for now. I am taking alendronic acid for now. Since taking them I have found my stomach to bloat. I would like to try and do it by taking more natural medicines. Has anyone done this or any advice would be welcome
Hi Yumnut ,
Just wanted to wish you a warm welcome to our community, thank you for joining us here 
It's great to see the wonderful support you've had so far from our members. Results can feel quite overwhelming when trying to make sense out of them, so we just wanted to let you know we also have lots of information on our website about understanding our scan results and things like fracture risk: theros.org.uk/information-a...
Hope this may feel helpful
Wishing you all the best,
Lulu
ROS Moderator
Thank you it’s definitely been helpful so far.
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