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failed fusion - what next - help

TerriTTerri Posts: 193
edited 06/11/2012 - 8:28 AM in Back Surgery and Neck Surgery
I've been posting Chris' progress under the topic "Chris' fusion" since his L2-5 instrumented fusion w/ L4-5 TLIF 10 1/2 months ago. Just this week, the ortho surgeon told us there was not as much bone growth as he would expect for 10 1/2 months and that the bone growth that is visible is not where he would want it to be.

Chris does not smoke, has walked almost daily (up to 6 miles/day), has taken calcium, avoided NSAIDS, followed the no BLT rules, etc....
Since Chris has been using a bone stimulator for only 45 days, we decided to continue on this course for the next 45 days and then have another CT scan before concluding that he has a failed fusion.....that will be 13 months post surgery.

What happens next if he does not fuse? I'd really appreciate hearing grom anyone who has been through this.

As always, thanks. Terri


  • My doc says if there is no fusion, they go back in, put in more bone graft material (his own bone or cadaver or a substance that is made), and sometimes more hardware.
    How old is Chris? Why hasn't he been fusing, has any possible reason been given?
  • We are searching for help after a failed fusion as well. My daughter is 26 and was diagnosed with DDD 6 years ago. After trying everything short of surgery to relieve the pain, she finally broke down and went for the surgery. It's been over a year and a half since she had the fusion (L5 S1). Apparently it never healed solid but they don't know why and she is now in just as much pain as she was before the surgery. We don't know what to do next. We probably will try seeing another Dr. It's so hard to know who to choose or where to go. Anyone have good advice?
  • Why won't her present Dr do another surgery?

    Many of the Drs arould here would NOT take another Drs problems.

    Let us know what you find out.

  • Dana - Chris is 57. Our internist worked him up for everything under the sun before surgery to make sure he was healthy enought to handle the recovery. He repeated a bunch of tests when is seemd like Chris wasn't healing on schedule and he has been unable to find any answers. That is why the internist recommended we go see another OS and set us up with one tht he knows that has had an interest in non-unions. Still no answers as to why he hasn't fused.

    Jill's Mom - I feel your pain and hope you can find some answers soon.

  • Boy, that is scary. How to know if something will fuse?
    I would say to find the very very very best person you can. Go to New York or LA or wherever and get this fixed. I'm so sorry you are going through this. I hope my own will fuse, it is too soon to tell.
  • Hi Terri, how frustrating. From what I have read on here, it seems non-fusion is sometimes treated with a 360 fusion surgery to stabilize the fusion from both the front and back. I hope and pray things start to improve for him soon. Take care, >:D< Cali-Sue
  • I've been following your posts and am so sorry you are having all these problems with your husband's fusion. I do not have any personal experience with non-fusion, but from others I know that they can go back in and basically repeat the surgery with a few changes.

    I guess I would probably choose a different surgeon, but even that would depend on the circumstances. There are many reasons for the non-fusion.

    I often read on these boards that another surgeon will not take on a case involving another surgeon's work, but I have not found that to be true. I think most surgeons would want the patient to wait a year before declaring "failed back surgery."

    I'm keeping my fingers crossed that the bone growth stimulator will help and that another surgery will not be necessary.
  • Hi Terri! I'm so sorry that Chris is having such a hard time! He has done absolutely everything right. I'm scheduled for my surgery May 5th for the non-union at L5/S1. As mentioned above, they are doing a 360 with a wedged cage at that level so that my spondy won't slide further. Also, they found my sacral screws are loose b/c of the movement. I would hate to think that Chris would have to go back in and do this all over again! He's had so many levels done. I'm going for a 2nd opinion w/the same OS that did Chris' surgery. I'll use the same surgeon I had last time-I feel confident w/him, but want a 2nd opinion to be sure someone else agrees. I would think that someone else would be ok w/working on Chris b/c of the distance to the original surgeon. They have to undertand that it's not practical to travel here. Keep me updated! I hope the bone stimulator works!
    :) Andrea
  • I was diagnosed with a non-fusion of my PLIF L4-S1, back in July and have been waiting patiently since for a doctor willing to fix it. The screws are loose and I have a lot of nerve pain as one particularly naughty screw wiggles in the L5 nerve occasionally . At last things are moving along for me and I have my op date, 12th March .
    I am going for a day of pre-checks and appointments with the different members of the team on Monday 2nd, so I will know more of what they are planning after that.
    I have not been given any reasons as to why there is no fusion and I have done everything I was told to, they say there is a small percentage who don`t heal and I am in that percent.
    I hope a solution is found soon for Chris, or that the stimulator helps since there is some sign of bone growth there at least .

  • You guys are the best!! thanks for the encouragement and information.

    Andrea - I will be anxious to see what Chris' doc says when he sees you. We will be returning to see him on 4/24 for Chris 12 month check-up (it will be closer to 13 months). We also have a f/u with the new OS scheduled for the same week so we'll have 2 opinions on the 12 1/2 month CT. I sure hope this does the trick for you.

    Viking - I'm interested in what the doc proposes on Monday. Good luck!

    The OS that did Chris' instrumented fusion didn't use BMP. The new OS we saw was involved in a lot of studies re: BMP and uses it regularly. From all that ER Nurse has posted, I know BMP can cause problems. On revisions that result from non-union, does the risk of using BMP outweigh the risk of another non-union? anyone know?

    Thanks, Terri

  • The 1st I heard of problems w/BMP was on Angie's post. I would certainly bring it up to both surgeons and get their take on it. My surgeon used BMP in my cage at L4/5 and it fused beautifully. Since I had no cage at L5..no BMP..no fusion. I know her situation is so scary and so sad. Maybe having the opinion of 2 surgeons will help. I wonder why the Raleigh surgeon didn't use BMP? Did he say why at the original sugery?
  • Andrea - I can't tell about the BMP from my notes from before surgery. Is BMP only used with cages? Chris only had a cage at L4-5. The rest of his fusion was just a plain old posterior instrumented fusion leaving the discs in place. Good luck. Terri
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