Use of Forteo (Teriparatide) in Posterolateral Lumbar Spine Fusion

Inclusion Criteria: * Patients aged 60-90 years with lumbar spondylosis, spondylolithesis, or adult degenerative scoliosis, including disc pathology, stenosis, deformity, instability, or postdecompression revision, who are scheduled to undergo three-level or greater posterolateral lumbar spinal fusion. * Willing and able to use a pen-type delivery system to administer daily subcutaneous injections. Exclusion Criteria: * Use of bone morphogenic protein (BMP) posterolaterally during the fusion procedure. * Previous spinal fusion at the intended fusion levels. * Prior use of Forteo (teriparatide). * Use of digoxin. * Paget's Disease of bone. * History of primary skeletal malignancy, presence of bone metastases, or previous skeletal exposure to therapeutic irradiation. * Elevated serum calcium, serum PTH \>70 pg/ml, 25-hydroxyvitamin D \<12 ng/mL, or active liver disease. * History of symptomatic nephro- or urolithiasis in the past two years. * History of malignant neoplasm in the past five years, except for superficial basal cell carcinoma or squamous cell carcinoma. * Carcinoma in situ of the uterine cervix treated in the past year.