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Failed Lumbar Fusion

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:27 AM in Back Surgery and Neck Surgery
I had a spinal fusion of L4/L5 in November of 05 I was so excited because I was told there would be a 95% chance of success. Well let me tell you I didn't fit into that category. My pain moved to other areas of my low back and my origional condition remains. I have had the hardware removed, more injections and MRI's than I can count and have just recently gone through an RFA. Looking for anyone that may have been though the same situation and found releif. I'm the type of person that is not going to give up but I have to tell you after 3 1/2 years you do get discouraged.


  • Welcome to the forum.

    I just had my L4/L5 fusion on Dec 19th so I can;t offer you much advice, but I can tell you that you are in the right place. There are tons of people here who care and have been through just about everything under the sun...

    Good luck and welcome to our little corner of the world..
  • I am so sorry to hear about your setback.

    For everyone's benefit, could you please tell us if your surgeon ever provided you with a reason for the failure, and if so, what happened?

    Welcome and Good Luck.
  • No not really, he said that sometimes some people just fall into that 5% bracket for no reason. My pain is now about 5X of what it was prior to surgery, I am dependent on pain meds. One Dr in Florida (LSI)claims that he can help but they don't have any contracts with insurance companies and about 35K needs to be provided up front. I am now 4th pain dr since the surgery and they just can't seem to isolate the cause. The physician that I am seeing know thinks the pain is coming from the facet joints hence the reason for the RFA. I'm only a week into that and they tell me that it takes about 3 weeks to see if it is going to work but from the way I'm feeling I don't have much hope. Thank you all for your kind words and support.

  • Hi Glenn, I'm in a similar predicament. Well, the surgery went well and I was told the fusion was coming along well, but the back and nerve pain persisted. I had a 2 level fusion and laminectomy of L4-S1 around 8 months ago and I still have so much pain. Statistics show that since more fusions are being done, the chances of patients ending up like us are on the rise and this is more prevalent in the US. I decided on this surgery in hopes that I'd get better. Like I was told prior to surgery, some people get better, some stay the same, and some get worse. It is a sad fact but true. I have had this pain going on 3 years now, and I'm a veteran of 2 back surgeries and all kinds of treatments. It is definately frustrating, but never give up. I believe that some new technology will come around that will benefit us. Until then, all we can do is keep fighting and have a positive attitude.
  • I'm sure you've heard that a million times now, huh? I wish I had more to offer you. I'm only 7 weeks post op and can't imaging suffering for as long as you have. I remember hearing the same statistics prior to my surgery and I thought those were pretty good odds. Unfortunately, for you that is not good enough. I hope and pray that you find help and get the comfort that you need. Don't give up and keep us posted. Keep the faith!
  • I am sorry to hear of your failed surgery. I think some surgeons refer to success as fusion taking place which is often around 95%. They neglect to mention the success rate of decreased pain is more like 80%, some would say lower. I am about 5 months post fusion L4-5 and it is going okay so far. I still have daily pain, but not bad, and I can walk without limping which is a great benefit to me. You might try to do a search here on SH for LSI as I have seen it discussed before with much skepticism. I will post some old threads below if you want to read them.




    I am sure there are more under old archived threads. Good-luck to you in your search for relief. Have you considered a spinal cord stimulator or implanted pain pump. I know these are last resort mesures, but I have read some success stories on here with them. Take care, Cali-Sue
  • Hi gburchell,
    Did they remove the disc or just fuse around it? I also have a failed L5-S1 surgery. Films indicate some fusion, but it's weak. They didn't remove the disc and I suspect that is why I'm still in pain.
    It's possibly due to the annular tears on the surface of the disc. Theoretically, the fusion and hardware should be keeping the pressure off of the disc. But the pain is still there. Tears are known to be very slow to heal at best. Many times they don't heal at all.
    Anyways, that's my reasoning to get a second surgery. I'm having the surgeon completely remove the discs. Thereby, removing the annular tears, and removing what I suspect is the source of the pain. BTW, the annular tears were present in 2 discograms. I don't know why they left the discs in the first time.
    I assume you had a discogram. If so, did the report indicate any annular tears?
  • Hi Glenn
    I also am sorry you are still in so much pain but glad to hear that you are a persistant person as that will make all the difference in the end.

    Now- if you didn't fuse and they removed the hardware- then what is keeping your vertebrae from grinding together (lovley thought LOL)?
    Hiker- Is there a reason why your Dr did not remove the disc? I suppose i am thinking that the disc needs to be removed for the graft to be put in place or is this not the case with all fusions?MAybe it is only where decompressionis needed so spacers can be placed in as well.
    I'd love to understand this so if anyone has answers then please share them.

    Glenn- I really hope you find an answer and healing soon.
    Blessings Sara O:)
  • I hate it when that happens.

    A shorter version....

    Please keep strong and focussed. You ahve found a wealth of knowledge, ideas and experience on these boards (but we are not medical professional) that may help balance your thinking and give you ideas to discuss with your own doctor.

    Can you clarify the reason for failure?
    Is it non - union?

    Take care
  • Yes the disc was removed and a cage inserted in its place. I have been told by sevearal Dr's the fusion looks very good and solid. Thanks again for your support...
  • Thanks for responding Angleback, yes they did remove my disc and inserted a cage, I'm told the fusion is very solid, hope this helps.

    Regards, Glenn
  • Thanks for your support, after three and a half years of searching and many of different doctors they have not been able to isolate the cause. I only know before any surgery's I had pain only in my right buttock and know I have pain on both sides of my low back, hips, and sill in the right buttock and live on meds. I can not find a comfortable position sitting or sleeping. With technology today you would think they would be able to detect the cause. Regards, Glenn
  • My L4-L5 and L5-S1 both tested positive for pain with the discogram. They only operated on L5-S1.
    They had removed only 1/3 of the disc, removed the lamina, and fixated L5 to S1 with hardware. They placed grafting material around the L5-S1 disc, on the left and right side. The material was to create a fusion on just the sides of the vertebra, going around the disc.
    I don't know why they chose to leave a bad disc in place.
    It would have made more sense to me if they would have just removed the entire disc and let the whole space fill with bone material. Hoping all goes well the next time.

  • I think that surgeons don't like to tell their patients that this has happened. The thing is that the surgery is technically successful in some cases, but it just doesn't relieve the pain and post op imaging might not show additional nerve impingement. A lot of us fall in this category, and we're left to ponder where do we go from here.

    I would like to know where I stand, because I feel worse after having a fusion done but I will keep doing what is necessary to have a better quality of life and not give up.

    I have heard that no one wants to put a failed back surgery syndrome label on a patient because insurance companies and other doctors will run the other way. Is this true?

    Well Glen, no matter what happens you have to remain strong and try to stay positive. Take care
  • Hi Glenn,
    Just re-read this post. Your symptoms are sounding familiar. Aside from the back pain, I have my sacro iliac joint moving out of place, causing the buttock pain.
    For years, I couldn't find a doc that would consider the possibility. They say the joint shouldn't move at all. By chance, I was at a physical therapist who recognized the problem right away and was able to treat it.
    When standing straight up, does your right leg seem like it's pointing too far right instead of straight ahead? Or like it doesn't want to move as smoothly as your left when walking?
    If so, it might be your sacrum slipping forward on the ilium.
    Just a possibility. It's hard to diagnose and doesn't show up on any xray, mri, etc. My doc poked me with her fingers to find where my hips were, etc. and found that things weren't lining up. Now, when mine slips out, I can get on the floor, do a specific exercise that puts it back in place and relieves that particular pain. And I stand about a 1/4" taller after. Need to adjust the mirrors in the car after with the added height. It's that noticeable.
  • I think that people, public and doctors "fog" you and think you are a pain in the A**!

    I have had a few recently unhelpful remarks.

    "Pain Room in your head....turn down the volume switch!"

    OMG! I nearly burst with rage! As if it were so easy!

    Stay focused and keep searching.

  • When laying down there are time that it feels like both sides are out. I have a hard time sleeping on either side for more than 5 minutes. Is there a site that may show the exercise that puts yours back in place?

  • I'd be very leery about going with a doctor that wants that amount of money up front and doesn't take insurance. Any reputable doctor has insurance contracts. Anyone like him sounds very fishy.
  • Glenn, I had my L2-S1 360 reconstruction surgery 2 years after a 3 level laminectomy. The surgeon said this would take care of my pain. After thinking for a while we went ahead...fast forward 3 years 2 months.

    I am now in more pain than before the surgery, developed a infection and had to go back total stay hospital and rehab 20 days. I have been told the the fusion is complete. They have done Ct and say no nerve impingement. They have given me no reason for still being in pain.

    Luckily i have a good pain Doctor who at least tries to help. I can only lay down for 15 min to a hour before the pain wakes me. With the help of a cane I can walk about 100 feet before the pain goes off the chart. A trip to the Doc or grocery store lays me up for days. I have been offered more pain meds but I refuse to be a zombie. I only take the bare minimum to get by.

    I have for now quit looking for answers, I have little trust of surgeons...my thinking has turned to if they are not cutting..they are not getting paid...When I find a Doctor I can trust I may try again...

    Best of luck in your search...no one deserves to live in pain...the older you get the worse it gets...
    good luck butterbean
  • First post, so some background: I'm 23 years old. I had a successful L5-S1 fusion in May 2007 (age 19) with rods and screws to correct a severe disc herniation at that level. I was pain free for over four years until September 2011. A CT myelogram revealed herniation at L4-L5, most likely due to increased stress from the L5-S1 fusion. I had a second fusion at L4-L5 in January 2012, connecting down to previous surgery so now am fully fused from L4-S1.

    It might also bear noting that my first surgery was done by a neurosurgeon completely posterior, and my second fusion was done by an orthopaedic surgeon with the cage being inserted from the side and the fusion being completed in the posterior. My first recovery took a full 12-14 weeks to be almost completely pain free; the second surgery only took 6-7 weeks to be pain free and off meds. After both surgeries I have had positive results with physical therapy and can walk regularly. Also, the bone has grown over the L5-S1 fusion making it "successful" and a recent xray revealed all hardware is in proper position and there are signs of healing from the second fusion as well.

    I am now about 11 weeks post op from the second fusion and my pain has come back in almost full force. This is the same pain that caused me to resort to surgery in the first place-- shooting nerve pain/sciatica in the left leg, along with the tingling and discomfort. It is not constant pain but when it shoots, it is a 9 or 10 out of 10 on the pain scale.

    My doctor recently put me on a steroid taper to see if my pain was reduced by reducing inflammation; this has been unsuccessful. He has ordered another CT myelogram to see if the herniation has progressed to L3-L4.

    I'm wondering if anyone else has had 3 consecutive fusions in different operations, or do most people stop when the surgery is not successful in removing the pain? I am unsure if I would go through another fusion if that is what my doctor recommends. If anyone has had experience with something similar, it would be greatly appreciated if you would share. Thank you in advance, I am certainly glad to have finally found these forums.
  • Emily, I am in a similar situation as you, I have 3 lots of surgery now & have
    had L3/4 L5/S1 fused, with cages to replace my discs,
    I have 2 rods in place & 11 screws then bone taken from my hip,
    My first op was anterior I spent 3 weeks in hospital, then 3 months in re- Jan
    The other 2 surgeries were posterior & again weeks in hospital & wheelchair bound for weeks,
    It's now 2 years since my last op and I am still in agony
    I spend most of the day laying in bed as the pain is unbearable, I still take Morphine
    plus numerous other drugs, I am going to see a new pain specialist soon & am hoping he will have a miracle
    for me.
    I wish you well in your recovery, keep your chin up & don't give up.
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