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Controversy on Fusion Time

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery
My surgeon tells me that he expects my fusion to take 6-9 months. He said that my 6 week post-op x-rays are to see if the hardware is still secure and in place - not to look for signs of fusion. Further, that it is impossible to see a fusion on x-ray and success is more or less determined by "how I feel". He said sometimes you "think" someone has a fusion and 2 years later realize it failed when screws start "popping loose".

So, my question is, why are some people reporting signs of fusion at their 6 week post-op visits? I'd hate to think my doctor is mistaken, but I know there are so many different view points on this subject. How does one know when they have a positive fusion? Does a lumbar fusion take longer to grow than a cervical? Same question for a multi-level fusion - does it require more time for a successful union?




  • I could CLEARLY see the fusion taking place on my x-rays Friday, which was my 6 week checkup. Could clearly see the bone growth. It was not as dense/dark as the other bones but they said by 3 months all restrictions gone with the rate I am fusing.
  • My specialist in Australia orders a CT and xray for your 3 month checkup to ensure that the bonegrafts are taking and how they are doing...
  • I have no idea why a doctor would say you can't see the fusion on xrays. I could see my fusion just beginning on my 6 week xrays. At 3.5 months I could see a lot of fusion on my xrays. I would be very uncomfortable if there was no way to check on the success of a surgery. Because the hardware keeps everything in place you could feel good but have non fusion. Anyway as always, I am not a medical expert and the opinions I express are just that "my opinions".
    Good luck and quick healing,
  • I don't really see much difference between what your doctor told you and what others are saying. I think he is speaking of a difference between "bone growth" and "fusion."

    It is possible to see signs of bone growth early on, but your surgeon is looking to see that the hardware is in place. He further states that you cannot see fusion on x-ray. I think he is speaking "techo-ese" meaning, you can see bone growth, but you do not know for absolute sure that there is fusion unless you go back in.

    Sometimes you hear stories from someone who was told they had fused, but when operated on a second time, while there is new bone growth, there is not a solid fusion. This was not visible on x-ray.

    I think most surgeons check for bone growth because their patients expect it. They become impatient and need to know something is going on and all they've gone through is "worth it."

    My surgeon does no imaging until the six month check-up unless someone complains of pain. (I had an MRI at ten days because I had a very bad new pain beginning the second day in the hospital and I complained a lot!) He feels that spine surgery patients do not need any unnecessary exposure to radiation, particularly just out of curiosity. After all, what are you going to do if you don't see signs of fusing at this point? Nothing will be done for one year unless hardware is out of place, and really, that hardly ever happens if you go to an experienced spinal specialist.

    I can't comment on your last questions. I know nothing about cervical fusions (and hope not to have to learn!!)
  • Josh,

    This is a great subject and one that is unfortunately close to my heart (or spine!) right now. I can tell you that I have had monthly x-rays and each time they have looked the same--hardware in place. The doc says like your doc, may not be able to see it. But then I get on this board, and like you, see a bunch of people talking about seeing their fusion at 6 weeks!!! Well, here I am at 4 months, as you know, and in a boatload of pain that came on about 2 weeks ago. So they ordered the catscan and will have the results on Monday. Again, if they weren't concerned when they didn't see fusion on the x-ray at 3 months--why the panic now and the talk of needing more surgery? I've been told by MANY people....that I should be "fused" by now...including medical people. One doctor said it is the same as a broken arm--you put the cast on for 6 weeks and it fuses. Maybe, just maybe, those of us with BMP only, like me, can't see bone growth because we aren't seeing the hip bone or cadaver or whatever. All I know is I am in severe pain and like you, I want answers. I had a heart to heart talk with a doc friend of mine last night. This man did fusions as the cutting doctor for 20 years. He said, "you should have fused by now" and "your original pain should have been gone in the moments after you woke up." He said "by putting in the hardware, they are relieving pressure that was supposed to be causing the pain." Not good, not good, not good. Then I hear others saying it could take up to a year to fuse--but is that "with pain" during those 12 months? Why would I still have the same pain? They created the space and secured it. The thing that bothers me is that my pain starts about 10 minutes after I wake up in the morning--I feel good for about 10 minutes--but right when I get moving--it starts to rub up against itself in there, since it isn't fusing, and I have the pain the rest of the day that simply escalates.

    The other comments make sense--what are they going to do anyway? More surgery? Well, my PA felt "yes, they would go in from the back and secure it." Well, this sounds crazy now, but I was originally told by others that I should have the 360 from the start--so really, this could be part II of the surgery--looking at it from the bright side. Josh, hang in there. People who haven't been in our position have no clue. At church today, I saw one of my former high school teachers. He had a fusion done back in the 80's and the hardware grew into the nerve...nothing they can do except give him 80mg Oxycontin 3 times a day. He was a world class softball player, weight lifter and now he and I commiserate over how many tears we've both shed over our backs. It will bring you down fast. Hope to hear more encouraging feedback. I'm just trying to give you my honest take.
  • Josh,

    Also, read the thread that Buckeye started on success stories. I read from the bottom up and had to stop because I started to loose it emotionally. In almost every case of success, the person "felt great out of surgery"--and "knew it had worked from the start" and "only had surgical pain." I was looking for a success story of someone like me--who felt about the same or worse at 4 months--and who woke up in wracking screaming pain--but I'm not seeing too many of those.

  • I don't see how fusing will take away pain unless I am missing something.

    As your friend said, the hardware and actual surgery should give you that instant relief unless the nerve is damaged or healing, but I don't even get that.

    My disc at L4-L5 was removed, and it was TOTALLY destroyed, and most likely was damaged for the past year and a half pushing against my nerves.
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