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Is it too early to tell if I have failed fusion?

MingMMing Posts: 1,127
edited 06/11/2012 - 8:29 AM in Back Surgery and Neck Surgery
Hi All!

I was just wondering if 8 months post op ALIF 7/1/08 L5/S1 is too soon to be thinking about a failed fusion. I know some of you know me already but those who don't I will give you some history. I was doing ok after my surgery until around Sept. I went on our annual Girls' 4wheeler ride and I was pretty sore afterwards and my back just seems to be getting worse and worse. I know have pain and numbness in both legs whereas, before surgery I only had it on right side. I also get the pins and needles feeling in my legs and feet that I didn't have prior to surgery. I just started what I call shooters in my lower back. This is when all of a sudden I get a severe pain in my lower middle back and it takes my breath away for a second. The pain also goes into my hips and outer thighs. I also have sciatic pain down butt all the way down to foot. I didn't have the sciatic pain after surgery until a couple of months later. I had a CTScan done in Nov or Dec and they said everything looks ok, not enough showing to cause my pain. Ortho took xrays and said fusion looks good and I had an EMG mid Feb 2009 and it showed no evidence of nerve damage or impingement.

Is it too early to jump to the conclusion that my surgery was a failure or am I just being too impatient and need to give myself more time to heal.


  • Hi Ming. Sorry to hear that you still have this much pain after 8 months. However, when I was still haaving pain issues after my fusion surgery, my surgeon was adamant that he would only consider my fusion failed if I still had significant pain 18 months to 2 years later. He was pretty sure that my issues were not failed fusion and he was right. At 12 months I had virtually no pain whatsoever and now at 27 months I am pain free.

    If your scans and EMG all look good then it seems like there is nothing major wrong and your pain may not be directly related to your surgery, but somehow indirectly related. During my first 12 months of recovery I got all sorts of new pains - lower back pains, SIJ pains, ankle and foot pains, etc. I even developed inflammation of the tibia/fibula joint behind the knee which impinged the sciatic nerve that runs down through that area - this caused similar sciatic pain to what I used to experience before my back surgery. All these aches and pains were due to 1) the slight change in geometry of my back and legs after surgery and 2) the significant increase in activity during recovery.
    Keep positive!


    ...an old timer here and ex-moderator

  • I am very very very very very interested in this thread. As many of you know from my "story thread" I am 4 months out and my pain is worse than pre-surgery. It is the same type of pain I had pre-surgery only worse. It has gone up and down--but the past 10-14 days it has settled into that chronic pain feeling. I am back to Oxycontin 2-3 times a day and it is miserable. My first PT appointment on Wednesday was what gave it away. I had thought I was just hitting a rough patch, but he said, "you are not fusing." Then he and my PA spoke and they ordered a ct scan--will get results on Monday. PT said I need another operation from the back this time to stiffen it up. If you read my story thread, you'll see there are dissenting opinions on how long it should take to fuse. I don't know what to think. I just know I have the same pain I've always had and it feels unstable. I love hearing that it could take 12-18 months--because the need for another fusion would be a disaster in my case. This is a tough way to live.

    Sorry to hijack your thread, Ming. To be honest, if you are just sore, then that is probably expected. I'd start worrying if your pain stays for days and days and is similar to pre-surgery pain.

  • What Bruce has written has been exactly what my surgeon has said. I am almost 4 months post-op, my CT scan looks like nice stuff healing, but I still have troubles. Surgeon lectured me again, reminding me he told me before the surgery that it takes 1-2 years to really know the full extent of success with a lot of these cases. He was adamant before surgery, and is reminding me now (even though I had a complication of stress fracture at L5-S1, it is healing and I'm back on "track" according to him).
    I have to believe them, and be patient.
  • My fusion was 9/25/08 at the L3-4 & L4-5 level. I was cut in the front & back. I was having the same exact pain as before surgery but lately the pain is getting better. I am in no shape yet to get back to work though. My doc said that some people get better in 3 months others 9 months, you just never know. So I am waiting for that day when the pain is completley gone. Now I am dealing with a divorce. =((

  • I appreciate all your input. Chuck no worries about hijacking my thread. I like to hear everyone's situation and will look back at your posts.

    I pray everyday that I just need to be patient and it just needs more time to heal. It's hard to stay positive when the pain is excruciating everyday and it's become worse than pre-op. I realize that it takes time but it seems that after 8 months I should start seeing some kind of improvement instead of steady decline.

    I am looking forward to seeing the neurosurgeon on the 24th and having a fresh set of eyes to look at my tests. I hope he reviews the images and not just the written reports cuz I always wonder if the radiologist misses something would anyone else catch it? The docs don't seem to view the images. Maybe they do and I am not aware of it.

    I'm at the point where I have a hard time standing upright again so I walk bent over like an old lady. I got muscle spasms when I was sweeping the kitchen and that wasn't really a strenous thing I was doing. My back makes clicking sounds in the lumbar area. I also feel like my back needs to be cracked in between my shoulder blades too.
  • Actually, Ming, sweeping and raking are some of the WORST movements for the back...so while it doesn't seem strenuous to you, it is the position that kills you.

    Ask the neurosurgeon to go over the films with you. (One of the surgeons I consulted with had a bag of oreo cookies hat he used to explain my MRI. We looked at the films, he showed me what to look for and how to read them, and then we ate cookies as it was the lunch hour.) Are you bring them with you to the appointment, or does he already have them, or what?

    When you talk about bending over to walk, that to me says "stenosis." Probably, you lean forward because it changes the shape of the discs which helps temporarily relieve nerve compression.(That's just part of the process...but you get the idea). Maybe you need to have those bone spurs removed and the central canal cleaned out to create a bit more space. Somewhere you have nerve compression...I hope the new guy will have some good ideas for you. I don't like the fact that you recently started to feel worse. I am eager to hear what the new guy thinks.

    Take good care ~
    Gwennie :?
  • Gwennie, you are so right about sweeping and raking. Whilst at 27 months I am pain free during normal activities slightly bending forward while raking, vacuuming, etc., definitely gets painful if I remain in that position for more than a few minutes. The pain quickly subsides, but it sure is a bad position for our spines.
    Keep positive!


    ...an old timer here and ex-moderator

  • Ming -

    I sure hope your fuse.

    I've been posting my husband's recovery under a thread..."Chris' fusion"...for 11 months. He had a L2-5 posterior instrumented fusion with a L4-5 TLIF 3/31/08. He is almost at 1 year post surgery. The last CT showed that he has not fused. He's been using a bone stimulator for the last 2 months. After 3 months of the bone stimulator, he gets another CT scan. Then, we'll see the original surgeon plus we've set up an apointment with another surgeon to get a second opinion. The good news: he's made great progress and is now walking 4-6 miles per day and on less narcotics than anytime in the last 4 years. The bad news: he still has all of the restricitions (no bending, lifting, twisting) and more pain than he was hoping to have at this point in recovery.

    We were expecting a 12-month recovery. Looks like it will either be longer than that or he will be declared a non-union. Either way, you have to just continue doing the right things everyday until there is a new plan in place.

    Good luck!

  • I have wondered this myself so many times. It's been 10 months post op for me and the pain was never relieved despite the surgery being technically successful. All I was told months ago that I was fusing well, but to try to hang on and wait for the pain to get better. This never happened and then I was told the fusion didn't work out and an SCS or pump would be beneficial for me. Recently I developed scar tissue at the L4-S1 level and it came about with a jolting pain from my back down to my foot. It was discovered by an MRI and currently I'm having horrible post ESI pain. I'm just as confused as you are.

    I have read about Failed Back Surgery Syndrome and from what I understood, if you have had one or more back surgeries and you're still having severe pain, then this may apply to you even if things went well during the operation. It is also called post laminectomy syndrome. I haven't been told if I am diagnosed with this. No one wants to say that their surgery failed on you, it's understandable. I have read about this trying to make sense of what is going on with me, and this is a very complicated matter because everyone has different timelines as to when you should be doing better and also, other complications might come about post op.
  • Thank you for your information. My CTScan said central spinal canal is mildly narrowed on a congenital basis, minimal posterior disc bulges at L4-L5 and L5-S1. Facet joints are minimally degenerated with posterior marginal spur formation at L4-L5 and smal posterior fact spurs L5-S1 of doubtful clinical significance. No evidence of disc herniations on any of those discs.

    Since you seem to have quite a bit of knowlegdge at which you explained was due to your researching your condition and how the spine works, which is something I am just starting to do....I was wondering if you could answer a question for me? If they did anterior discectomy and fusion of L5-S1, doesn't that include removing the disc? If this is so, then how can I have mild buld there now?

    I also noticed the same personread the report and dictated it. Is it normal to only have one person to review these? I always wonder if the radiologist overlooked something and my docs only seem to go by the written reports and not the films themselves. I guess I just worry about too much right now cuz I was not expecting to still be out on disability when spring came. I'm sick of feeling worse day by day instead of better. I want some of my life back. I realize I will never be painfree but I'd love to be able to do some of the things I love to, like taking long walks in our woods or on our country roads or taking my 4wheeler on the trails in the woods. Heck, a simple drive downtown in my own vehicle is getting too much for me.

    I have to call tomorrow and get my xrays, and EMG reports and images. I think I have to bring them with me. I have an xray of my back that was taken 2 wks after surgery cuz I wanted to show the kids what was in my. My son said it looks like I have a pizza table in my back. Those plastic things they put in pizzas to keep the top of the box from hitting top of pizza lol.
  • Thanks for all of your information and advice. I haven't done any yard work but I sure would love to be out there doing it. I did some a couple of months after my fusion and that was a bad, bad mistake. I didn't take it easy like I was supposed to and I think that may be what's going on. The pins and needles part is scareing me the most cuz my EMG shows normal but I'm still getting them. I just know and feel it in my heart that there is something there and they are just not seeing it.

    Thanks again to all My Spiney Friends and I pray you all have many pain less/free days!
  • My questions have been answered. Some may already know this so forgive me for repeating myself. I found out on Tuesday when I went to see a new doc that I do have a failed fusion and 2 broken screws. I knew there was something wrong and I couldn't get my docs to listen. That's why I took it upon myself to get another opinion from a different doc. I am so glad that I did.

    I picked up a bone growth stimulator on Friday and am going to start it tomorrow (which technically is today since it's now 12:08am lol ).

  • Ming,
    I am so sorry to hear that the screws broke. You've been through so much...hang in there. I've written elsewhere that my last CT Scan showed 80 percent fused--yet I still have pain 4 months out...it seems to be activity related...and I am stubborn. It is sobering to read your story and to see that you also were told you were fusing and yet you were not. I don't understand how they could make that kind of mistake. I have a doctor friend who wants me to have an actual MRI as opposed to the CT Scan. Well, I hope you are feeling better and get resolution....it is a tough way to live.

  • Hang in there. I am praying for you and that your situation will get better

  • Hi Ming, all the best of luck to the bone growth stimulator. At times like this, we would try anything. I will be praying for you, for strength to keep you going. Don't give up just yet.
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