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What is the bone won't fuse?

B52BB52 Posts: 247
edited 06/11/2012 - 8:39 AM in Back Surgery and Neck Surgery
Hey y'all! Here's a quick question for the crowd. Monday, I had my one month post op check up, which by the dr's account, went well. One thing he said that I didn't think about 'till just now, though. When we looked at the x-rays on the lightbox, I asked him did he see any sign of fusion yet. Almost forgot..I had an L5-S1 PLIF done. Anyhow, he said he didn't see fusion yet, but that it might take a month or longer to see anything. Cool, but the part I am concerned about, and almost forgot: he said it may take longer to fuse and then again, some people may never have a fusion. Hmmm.. I know it's early to worry about that, but if I never had the bone fuse, what would that mean? I'd be held together by the screws and rods for the rest of my life or what? Any thoughts out there? I don't know how that slipped my mind until just today, but it did.

Y'all stay warm


  • SpineAZSpineAZ WiscPosts: 1,084
    Hi B52:

    Does the doctor have you using a bone growth stimulator? They are known to aid fusion. I used one after my cervical fusion but have also heard about them used for lumbar fusions. Since you are only one month in you could wait until your next appointment - if you'll see him again soon. If you have any history of smoking in the immediate time period before the surgery sometimes a bone growth stimulator helps as well (as it can take a while for the body to rid itself of the cigarette chemicals that impair fusion)

    And many people have hardware forever regardless of how well bone fusion occurs. But in order for the fusion to really work the bones must fuse and work together with the hardware. Hardware alone won't fix the problem - it has to work with the bone fusion.

    Also, does he have you avoiding meds like advil (ibuprofen), alevel (naproxen), and aspirin? Many doctors recommend avoiding those as they can impair fusion.

    Now, with all that being said, I'm having XLIF (lateral method of lumbar fusion) in February (instead of the 360 degree fusion they planned first). The plan is to remove my hardware from 17 years ago at L4-S1. And then to fuse L3-L4. BUT, if they find L4-5 is not as fused as they'd like they may do the hardware L3-L5. I have some symptoms that appear to be generated from L4-5 so if there's not a total fusion there they will try again. Movement in that joint, even with the hardware, is possible and that could be causing the pain.

    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Morning to ya AZ! I hope yer doing well out there in the valley. No, I got away from that smoking years ago. What a stupid habit eh? What kids won't do to look cooll though!

    No, the doc hasn't got me on a bone growth stimulator, and to tell the truth, I don't even know what one is. Is it like a TENS unit or something?

    Ya know, the doc didn't mention taking NSAIDS or aspirin, but after reading on here and a little other research I'm going to stay away from 'em. I don't usually take that kind of thing anyhow, so it's no biggie. I do want to give this operation the best chance it has to work though. Thanks for the comment eh? I have been, well not worried, but a bit concerned about that throughout the day.

    Feliz Navidad,
  • My surgeon said it's like a race to see which will happen first, the fusion or the hardware loosening or breaking. The hardware isn't meant to last forever, just until the bone has a chance to fuse. If you don't fuse, chances are that you'll need to have your fusion redone as I did.
    Some ppl dont fuse for up to a year. I doubt a month after surgery you'd see any sign on fusion at all in a xray. They usually check by sending you for a Ct scan. Xrays are usually just taken on your visits to ensure the hardware is still in place and everythings is as it should be.
    It's way to early to worry about a non fusion yet so dont stress over it.

  • SpineAZSpineAZ WiscPosts: 1,084
    A bone growth stimulator is worn around the body and applies a low electrical current or ultrasound to the fracture.

    There's a picture of one on this site:


    I used a cervical one after my cervical fusion. I had to wear it 4 hours per day. I didn't feel anything, but since it was close to my neck it would interfere with my cell phone but had no other problems.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • Hi Aaron. I've had a 3-lvl ACDF at C4-7, and although I'm completely fused at C4-6, fusion is much slower at C6/7 and it's not yet fused. After this much time, it probably will never fuse and there is continued movement at that area.

    My surgeon has said that eventually he may need to go back in posteriorly at that area and put in a cage to stabilize that area of my spine. However, because I'm not having any significant symptoms with regards to this non-fusion, there's nothing we need to do at this point.

    I have to totally disagree with what Christina posted. If all of us that have hardware in our bodies were in a race to see which happens first, fusion or our hardware breaking, then we'd all be in a boatload of trouble. Despite what she posted, our hardware is meant to last our lifetime, as long as no problem arises. The hardware works with the fusion to stabilize the area and eventually bone should grow over the screws and some of the plate.

    Don't worry about fusion yet. I wasn't checked for fusion until three months post-op, so be patient. As long as you take care of yourself, you'll have the best chance at fusing.

  • Do not worry about fusion at this point. Just follow all your doctor's instructions, eat a nutritious diet, drink lots of water and other fluids, and walk, walk, walk. Having a positive attitude is important as well, so try to let go of this worry.

    Bone growth stimulators are not a part of the typical fusion surgery. They are used if there is something in the patient's history that indicates there might be a question about fusing, or if a past surgery shows the patient is slow to fuse. I'm sure there are other reasons, as well.

    My surgeon does not even X-ray early to check for fusion unless the patient complains of pain or a problem. He feels it only causes more exposure to radiation and is only done to satisfy the patient's curiosity. Incidents of non-fusion are so rare now with the new hardware and bone-growth products that he does not feel it is worth the cost and exposure to radiation for the patient. I think he may do it one time at 6 months. I had an x-ray at 3 weeks because I had a new pain and he wanted to be sure my hardware was where he placed it, and I don't recall having one again at 6 months....

    I agree with Cath's comment about hardware. It is meant to last. In this day and age, it is never removed unless a problem develops...either a screw breaks or comes loose, a patient is allergic or has a reaction, a screw is hitting a nerve, etc....Otherwise, it is left in. My surgeon removes hardware in about 2% of his patients.

    I suppose different surgeons handle non-fusion differently...but, usually there is a revision surgery. Sometimes all that is necessary is to repack the area with more bone or bone-product. Sometimes they have to remove the original hardware and redo the whole procedure. I imagine there are different ways to handle the situation depending on what is wrong. This does not happen often. Some people just take longer to get going on the bone growth than others!

    Just be sure to walk a bit several times each day. This gets freshly oxygenated blood to the surgical site and it also stretches out the spinal nerves. This helps to keep scar tissue from attaching to the nerve and will help promote fusion. It is not important how far or fast you go. Walk on a flat, even surface. Now is not the time to take up hiking in the mountains, or even the hills. And remember to avoid all activities that involve bending, twisting, reaching up or to the side; avoid all activities where your body will be subject to vibration, bumpy roads, etc. and exercises where you bend forward OR to the back. It is just as bad to "arch" your back as to bend from the waist. Remember, you can "bend" if you hinge from the hip and keep your back flat as a tabletop. The first three months are the most difficult and the most important.

    Take good care,
  • Thanks for taking the time for your reply. I'll quit worrying for now. I have no real reason to fret. Actually, I feel like I am doing well. My incision healed super quick, I am in no real pain and I feel, well great considering what all has been implanted in my back. I walk every day and I think I'm doing everything correctly. My nature makes me a worry wart. This likely ain't the last time you'll see me on here worrying over nothing!

    Thanks and much aloha
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