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No fusion due to nicotine or weight loss?

AnonymousUserAAnonymousUser Posts: 49,662
edited 06/11/2012 - 8:27 AM in Neck Pain: Cervical
I am new here and tried posting this in another forum and did not receive much response. I don't know if it is because no one saw it or they just don't know how to respond. So, I figured I would try again this way.

I have had three ACDF surgeries as shown below. I quit smoking the day of the first two surgeries and all three levels fused within three months. Each time I fused, I would start smoking again. My last surgery was on 12/16/08 for levels C6-C7 (which I believe should have been included in my 6/23/08 surgery) and due to many different things (stress, quickness of the surgery date, depression, etc.), I had difficulty completely quitting smoking this time. I never smoked a whole cigarette at once but I would have a hit of my boyfriends here and there and sometimes I even went for days or a week without any. I was so mad at myself the whole time too!

Last Wednesday was my 6 week post-op visit and I am not fusing. I was almost in tears. My doctor says "you've always grown bone like gangbusters but I don't see much this time". He says my constant shoulder/back muscle pain is not getting any better because I am not fusing. He did not ask me about smoking but he knows I was a previous smoker. He thinks I am not fusing because I have lost weight (only about 6 lbs) and told me to gain it back asap. He has also ordered a bone stimulator. I will NOT have another cigarette or be around any until I know I have fused this time too!

I am also supposed to return to work on 2/17/09 after being on disability since June 2008 (tried working 8 days in November but too much pain). I'm terrified since I am not fusing but afraid of losing my job in these tough times. My doctor and I will make that decision this Friday.

I'm sorry for being so lenghthy. I'm just extremely upset and hating myself right now.

I have a few questions that I am hoping some of you might be able to comment on.

Has anyone heard of no fusion due to weight loss?
Has anyone started fusing after 6 weeks post-op?
Has anyone had any luck with a bone stimulator?
Why have I heard C6-C7 are the toughest to fuse?

Thanks for any input!




  • I can only answer one of your questions, and it's only because of what my surgeon told me. (BTW, I too am a smoker.)

    The C6-7 is the most difficult to fuse because it moves the most whenever you move your head, in any direction. My surgeon wants to see me in June to check out the C6-7 and see if it's fused, so I have to assume that fusion does continue past 6 weeks.

    I used a bone growth stimulator for the first three months even though my surgeon likens it to voodoo. But we decided every little thing to help it along.

    Good luck.
  • Thank you So much for replying.

    I was wondering if you stopped smoking for your surgery or if you have continued to smoke. I find that so strange that the two levels above have fused but not C6-7. Does your doctor have you wearing a collar? Do you have any pain due to this level not being fused?

    Thanks again,

  • Laurie, sadly, no, I didn't stop. I have tried to cut down, though. My internist (who I saw at my pre-op testing) said it would be difficult to stop during this stressful time so he didn't push. My surgeon and his assistant have made it a non-issue - we've never discussed it.

    Like I said before, the C6-7 is a toughy with all the head movement, but I'm not wearing a collar. I do continue to have pain and muscles spasms, but the PA thinks it's because I need PT. I started PT, but got laid off last Thursday so no health insurance.

  • I'm so sorry to hear about your job. I hope you can figure out a way to take care of your health. Did they offer you cobra? I may have the same problem if I try to return to work next week. They just put me on cobra last month.

    Thanks for all of your information. I wish you all of the best and hope you'll keep me informed on your status.

  • MetalneckMetalneck Island of Misfit toysPosts: 1,382
    Has anyone heard of no fusion due to weight loss?

    No ... I have lost 30+ pounds post my second ACDF

    Has anyone started fusing after 6 weeks post-op?

    Yes ... I was fused 6 weeks after my second ACDF

    Has anyone had any luck with a bone stimulator?

    Neurosurgeon for first, had me use one ... Didn't fuse after 14 months ... Orthopedic surgeon who did my second doesn't use em.

    Why have I heard C6-C7 are the toughest to fuse?

    They are all tough to fuse ... depends on surgeon .. hardware .. cadaver v.s. harvest ... smoking ... collar type ... STRESS ... calcium intake ... and at least a million other factors.


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  • I had an ACDF on c6/7 in late may of 2007...i fused just fine and started back smoking in November of 2007. NOW...I started having bad pain again in August of 07 and my NS did the good ole myelogrom and it turns out that my size (285) and the plating w/screws cause mild bulging at the levels above and below.

    I'm now pretty well pain free in the cervical region after multiple ESI's and PT but, don't get me started on the thoracic and lumbar spine...it's toooooooo sad.

  • I wanted to thank you all for your replies. I guess it just goes to show that every situation is so different.

    I still have not received the bone growth stimulator from my doctor. I see him again on Friday to see about returning to work on Tuesday, 2/17. I don't think he will want me to go back yet if I am not fusing. I am still not even 2 months post op from my last surgery. I haven't touched any nicotine or been near any for over a week now and I've been eating so much junk food just to please the doctor and gain back a few pounds. I'm very concerned and depressed over this since I have always fused in the past. I'll see what happens on Friday.

    Thanks again,

  • i was told by my surgeon to quit smoking, i did for 8 months,and now i'm on chantix-- it works for me, some people who smoke fuse and some don't i guess everyone is different,i know it's hard not to worry about what your going through, but try to be positive, and tell you dr your depressed,maybe they can help with that,hope everything goes ok for you. the bone stimulator should help, others have had positive results.
  • I saw my doctor today and received my bone stimulator. What a lovely looking piece of equiptment. I sure hope it works.

    We discussed the back and shoulder pain that I am still having with not much relief from the medicine he has prescribed. He asked me if I wanted a shot in my back. I am very hesitant about any shots as I have never had them for these problems. I asked him about the Fentanyl patch because they gave that medicine to me (through an IV) after a very painful discogram I had last December and it worked so well temporarily. I was wondering if any of you can give me your experiences with cortisone shots and the Fentanyl patches. I see the pain management doctor this Wednesday.

    Thanks in advance for any input.

  • i never had the patch for pain, just injections (cortisone) they helped me for a while, they also do trigger point injections..
  • Thank you for the reply. Don't they inject the cortisone into the exact spots where the pain is? I know cortisone shots can be very painful and I guess that is what is making me really hesitant. I don't want to have more pain than I already do.
  • I love mine. I have surgery scheduled for March 26 (acdf c4-c7) and use Lidocain instead of the Fentanyl. It takes the edge off but it does not completely get rid of the pain. I am a needle phobe so I am not keen on getting shots either.

    I would discuss the pros and cons of the shots and patches with your pain management MD and go from there. Let me know what they say! I need all the advice I can get.
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