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What if you don't fuse?

JoyJJoy Posts: 560
edited 06/11/2012 - 8:26 AM in Back Surgery and Neck Surgery
Just what if? Then what happens? Will it create more pain? Will you absolutely have to have the hardware removed and start over again? Since I'm still having pain at 6 months, I'm getting a little anxious. Seems all progress stopped at the 4 month mark.
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Comments

  • I did not fuse and had the revision done, it was done posterior and it was a very difficult recovery. A few months ago my dogs vet told me had the same surgery and did not fuse and he left it alone, he says he has some pain but not enough to keep him from working. My surgeon told me if I did not have the revision I would always be in pain mgmt, well I am still in pain even after the revision, more so than before. It's a gamble and not everyone has the same outcome. I wish I had left it alone.

    Sharon
  • I really appreciate hearing that. Because I like Joy have often wondered. I just always thought if I didn't fuse the revision was the only answer so I'm glad you posted that piece of info about your vet's decision. I already know I DO NOT want to go through the revision surgery.
  • I don't know what I'd do. I'll just be having a first fusion next week. If it doesn't help in the long run I think I may lean towards a revision if it would "supposedly" help...especially if I'm in as much pain as now-hell, I'm having a fusion to stop the agony...but to know you'd probably not get better, would you definitely not do something, anything? That's too much for me to worry about now, though, as it probably not happen...but who knows

    Joy, I hope you start to come about soon and start to feel better-try not to worry yet
  • I've prayed so hard that my fusion takes. However, if it didn't, I wouldn't think twice about a revision. The pain was unbearable during pain flares, and I know I could never continue to live like that.
  • RangerRRanger on da rangePosts: 814
    hey Joy,

    It is still early at 6 months, it took me almost a year for the n/s to see some serious fusion taking place and the x-ray was inconclusive so I needed to have a CT scan to actually see the fusion.
    I can relate to your anxiousness but I am learning to just wait and see. We are all different and we all heal at different rates. I always think about the "what ifs" too, but it is what it is and we will deal with whatever comes about.
    Best of luck to you and take care.
    Ranger
  • I am not fused 18 months post TLIF. I have many issues, so it's sort of complicated. I have had one side of my hardware removed, and am having the other side removed next week even tho not fused. Will post update next week on what he decides to do-if just hardware removal and the other issues or if he says it's unstable and has to put in more hardware after bad hardware out.
  • I have had 2 xrays since my surgery and an MRI..my doctor never indicated how much fusion had taken place....I see him this friday (5 months post-op) to discuss continuing pain and my return to work.....I guess how much fusion has taken place is a good question to add to my list!
    Hope things get better for you Joy!
    Donna
  • I am at 17 weeks approx and we have not seen even a little cloud on the xrays. I am getting discouraged as well. I am a non smoker, non drinker, fairly healthy, following restrictions etc and still nothing. There may be something that just cant be seen, we dont know.

    I wouldnt hesitate for the revision if called for. Since there is much facet arthritis, my goal is a solid interbody fusion. I will welcome any relief to the pain.

    Hugs,
    Shell
  • RangerRRanger on da rangePosts: 814
    hey Shell,
    that is really early to see any fusion taking place. I too have never smoked,
    eat healthy, stay very active, and only socially drink rarely. It was almost a year till we saw fusion taking place and that was with a CT scan as X-rays
    were not clear enough.
    Take care and I wish you a complete fusion.
    Ranger
  • for all the encouragement! At 4 months, little clouds were visible. I won't have xrays again until Feb. (insurance issue). I just hurt so dam* bad! I try not to take the pain meds but once a day, but it's 8:30 a.m. and I've already taken them. Is it too much to ask to have just ONE pain-free day? Sorry...I'm having my own little pitty party here and forgot to bring hats for you guys! I'll get past this, I'm sure. I've also got an ear infection that I've had for 3 weeks now...one ear plugged up so bad I can't hear well. Just too much to contend with some days, you know? Ok, enough said...party's over! Will try to have a better outlook now.

    Happy New Year to everyone and please stay safe!
  • Thanks, its just hard ~X( to stay patient when you see people posting about confirmed fusion starting so early. I am not talking about being solidly fused by no means, just a bright white dot would make me happy,lol. I am so happy for them of course, just want to know why my body cant cooperate :W.
  • As a former manager of mine used to say, you can visit Pity City, but you're not allowed to live there ;)) . Believe me, we all take that train stop!!

    Hope you get some relief soon. I find that stress (either external or self imposed) almost always makes my pain worse. May or may not for you, but try not to to worry, easier said than done I know.
    >:D< >:D<
    -Melissa
  • Hi, I had not fused in 6 months and the pain increased instead of lessening, so I had another myelogram/ctscan. On 12/4, I had posterior surgery to have hardware put into L4/L5 where I'd had ALIF with cages/BMP in July. Once he was in there, he saw how bad my L3/L4 was...basically it had nothing holding it in place that wasn't seen during the ALIF. He put in screws and rods for both levels. I have felt a world of difference this time and hopefully I'm on the road to getting better this time. I've had a couple of days lately where I've only had to take pain meds once during the day. I'm really more sore and can tell that now I'm going to be fighting the muscles, ligments, and spasms, rather than the bones popping, grinding, and hurting so bad.

    I know it's still early but I'm so optimistic that I'll be somewhat normal again and not live in pain. It can happen! Good luck to everyone and hope you all do well and find answers if you are still having bad pain after your first surgery.
  • I, too, have worried about what happens is I don't fuse! My surgeon has told me (at 4 months) that I could stop wearing the brace - his nurse said if he had not seen fusion on the x-ray he would still have me in the brace. But, since I did not see him after these x-rays (he just looked at them and had the nurse call me) I could not ask all my questions.

    What has your doc told you about your progress?

  • ernurse, I'm wondering how you are today after what you have been through? It's been almost 6 mos since my ACDF and still my x-rays do not show any bone growing. I'm in the process of getting another doctor because my ***hole boss let me go the day I came back to work after rushing back to work to make sure I wasn't out too long and now I have new insurance. Of course my NS doesn't take my new insurance. I was even still post op and the office manager told me I had to leave because they didn't take my new insurance...anyway, I'm a little bitter over that. So hopefully I find a new doctor who tells me that everything looks great, but I have a feeling that is not the case. I am having almost the exact same pain as I had prior to the surgery. I had about a month of relief and then back to the pain. I'm on a regiment of Fentanyl, gabupentin (neurontin), and percocet.

    I really hope you are doing better. There has to be a light at the end of the tunnel. Sorry to vent, but it's so hard to find people that understand what I'm going through.
  • You're still very early out from your surgery. It can take up to two years to fuse. What I find interesting is most people's opinion of their fusion surgery. Fusion does nothing for pain relief. It's intent is to stabilize the spine to prevent any further damage. The other procedures done in conjunction with your fusion are designed to relieve your pain.

    Nerves take a long time to heal after this type of surgery. Its possible they may never heal. If they don't heal, you can take solace in knowing that you should not get any worse if all the procedures were done correctly. I'm only 19 months out from my 2 level plif, 10 months from hardware removal, and still have issues in my lower legs as a result from my surgery. You have to try and go with the flow, cause it just takes forever to heal. You shouldn't dwell on the WHAT IFS.

    Dave
  • Hello all...I had my surgey in April of 2011 and I never fused. My doctor wants me to have a second surgery but I am not completely sure I want to have it. I was wondering if anyone else is experiencing legs that feel like jello or numbness of tingling? I am contantly worried that these are signs that I am going to become paralyzed. Any insight to my concerns would be greatly appreciated. thank you.
  • rodriguezbrrodriguezb Posts: 2
    edited 02/25/2014 - 7:16 AM
    I had my ACDF done in May of 2013 and I did my follow-up in December 2013. The X-ray showed no fusion, but the CT scan showed minor signs of fusion. The doctor told me he recommends second surgery if it doesn't fuse. The only pain I feel is just stiffness on my neck and when I stretch my neck I can hear cracking of all muscles or tendons, but the pain is not so great that I have to take any pain medications. I workout almost every day and I have been practicing Karate since a month after my surgery. Before, I could not sleet comfortably, but now it feels much better. Just be patient, it will heal. I don't think I will be going for a second surgery even if it doesn't fuse; it is just too risky.
  • Joy said:
    Just what if? Then what happens? Will it create more pain? Will you absolutely have to have the hardware removed and start over again? Since I'm still having pain at 6 months, I'm getting a little anxious. Seems all progress stopped at the 4 month mark.
    Studies show that ACDF don't work as well as ACD. If a plate is in place then the nerve is probably decompressed.

    Chances are your surgeon didn't properly prepare the vertebral end plates. It sounds like you have a piece of bone or a cage rattling around in there.

    If you got a good disk replacement (not the kind used in the US) it would not matter if if fused. NeoDisc is held in place with screws. All it is is silicone wrapped in a carbon fiber weave. It acts like a real disk. Artificial disks used in the US don't act like a real disk.

    It is interesting to note that the disc replacements used in Europe, South America and Asia all all American made. Do some research from unbiased sources.
  • ChuckRoastChuckRoast Posts: 37
    edited 02/27/2014 - 3:41 AM
    dave said:
    You're still very early out from your surgery. It can take up to two years to fuse. What I find interesting is most people's opinion of their fusion surgery. Fusion does nothing for pain relief. It's intent is to stabilize the spine to prevent any further damage. The other procedures done in conjunction with your fusion are designed to relieve your pain.

    Nerves take a long time to heal after this type of surgery. Its possible they may never heal. If they don't heal, you can take solace in knowing that you should not get any worse if all the procedures were done correctly. I'm only 19 months out from my 2 level plif, 10 months from hardware removal, and still have issues in my lower legs as a result from my surgery. You have to try and go with the flow, cause it just takes forever to heal. You shouldn't dwell on the WHAT IFS.

    Dave
    Fusions are done for decompression and that can and will reduce pain.

    Fusion to correct instability is a recipe for more surgery. Instability is caused in part by problems with ligaments, muscles and tendons. Ligaments are what hold bones to other bones. Overly stretched or damaged ligaments cause/allow subluxations. In countries where they do advanced spine treatments ligaments are repaired with stem cells.

    Many spine surgeons in the US don't understand the functional anatomy of the spine.

    First, the interspinous ligaments run from the lower edge of one spinous process to the upper edge of the next one. Now we’ll add the supra-spinous ligament to the picture.

    The supra-spinous ligament merges with the interspinous ligaments. It runs the whole length of the vertebral column, connecting the tips of the spinous processes. The supraspinous ligament serves as a midline attachment for some important muscles. These ligaments help to limit flexion of the spine.
    The structure, or structures, that chiefly limit flexion of the vertebral column is the series of short ligaments that hold the laminae together, which are known collectively as the ligamentum flavum.
    The ligamentum flavum lies on the front of the laminae.

    The ligamentum flavum goes from one lamina to the next all the way down the spine. The ligamentum flavum is made of yellowish fibro-elastic tissue, hence its name, which means yellow ligament.

    Then there are the two ligaments which hold the vertebral bodies together - the anterior and posterior longitudinal ligaments. The anterior is the stronger of the two. The anterior longitudinal ligament covers the front and sides of the vertebral bodies. It runs the whole length of the vertebral column.

    The anterior longitudinal ligament is thick and strong. It’s attached to the upper and lower edges of each vertebral body. It limits extension of the spine. In extension, the tightness of the anterior longitudinal ligament helps to prevent backward and forward movement of the vertebral bodies relative to each other.

    The posterior longitudinal ligament runs along the back of the vertebral bodies. The posterior longitudinal ligament. It’s narrow where it overlies each body, and it widens out to cover the back of each disk. The posterior longitudinal ligament helps in a small way to limit flexion of the vertebral column.

    A lot of physical therapist have their patients stretch too much. When you get older ligaments lose their elasticity and vertebrae become unstable. American surgeons in their ignorance cut ligaments.

    Here's a diagram of the ligaments. http://www.eorthopod.com/sites/default/files/images/thoracic_spine_anatomy09.jpg


    Here is a basic explanation of spine anatomy. not permitted
    The fact is, the spine industry folks, i.e. surgeons are not up to speed on the bio mechanics of the spine. They are not engineers. They are trained how to cut and sew but they lack the training and in many cases they lack the desire and or grey matter to fathom the mechanics. People get surgery, it fails and the surgeon is at a loss to explain why.

    Link removed, not permitted.Please read the Forum rules
    Post Edited by Liz The Spine-Health Moderator Team


  • I have had 2 xrays since my surgery and an MRI..my doctor never indicated how much fusion had taken place....I see him this friday (5 months post-op) to discuss continuing pain and my return to work.....I guess how much fusion has taken place is a good question to add to my list!
    Hope things get better for you Joy!
    Donna

    Hi dbullwinkel 

    Did you said that you was 5 month post op and still out of work? I am almost 3 months post op and was wondering how soon will it be before I can return to work. I'm a technician and my work is physical and require me to lift up to 60 lbs. 

  • ArtsygalAArtsygal Kentucky Posts: 27
    I would say don't dwell too much on what if & cross that bridge when and "if" it happens, life is unpredictable! 
    I did not fuse from acdf over 2 years ago and the 24/7 pain since really changes life.  Spending most of your time in bed isn't my idea of "living life".  That said, I am so looking forward to revision surgery in couple of weeks for my shot at getting pain to a manageable level where I can be active again.
    A good question to ask during post op visits is "am I fusing" I never heard the word fused, just told everything is in place and looks good. I assumed (never do that! !!!) that meant I had fused,WRONG! 
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