I am scheduled for a spinal fusion in two weeks. As part of the preliminary work-up, my surgeon ordered bone scans and blood tests to look for osteoporosis. I'm worried now that if it turns out I have osteoporosis they won't do the surgery. Is that possible?

You are in good hands if your surgeon is routinely screening for osteoporosis and pretreating patients who might be at risk for fractures from brittle bones associated with osteoporosis. You may not be cancelled for surgery. It depends on a number of different factors. Your age, the quality of bone density, your levels of calcium and vitamin D, and your overall general health are all important factors in the decision.

Information on the quality of bones is important if your surgeon was planning to use instrumentation. Instrumentation refers to hardware such as metal plates, screws, pins, or wires to help hold the bones together until the fusion is completed. There is a risk of implant loosening and pseudoarthrosis developing in the presence of osteoporosis. Pseudoarthrosis means there is movement in the spine where the fusion is supposed to hold the vertebral bones steady without movement.

If osteoporosis is present, surgery may be postponed and rescheduled by a few weeks. Treatment to supplement vitamin D or to address the balance between bone tear down and bone build up may take a few weeks to months. But before jumping the gun and making any assumptions, get the preop tests done and have your surgeon go over the results with you. You may be worrying about something that won't happen.