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Failed Lumbar Fusion

janeellenjjaneellen Posts: 37
edited 06/11/2012 - 8:41 AM in Lower Back Pain
I am interested in your experiences with failed spinal fusions.The gentleman that I trusted with my life three times,did a MRI,EMG,and a Myelogram and canceled my appointment. I was told through his secretary that he would not see me and that "there was nothing surgical he would do".I had a friendly professional relationship with this kind sir,and he promptly corrected my other two "conditions".She made it clear he knew what the problem was,but was not willing to correct it. My attempt at a second opinion, at one of the top hospitals in the U.S., got me a very inspirational speech from a top notch neurosurgeon.He in no certain words,informed me that I did not fuse.He was so animated when he was telling me to "aim high"-and pursue anything I wanted,that I was too dumbfounded to say,"Wait a minute-could you stop preaching and give me the medical facts"{that is an edited version of what I wish I had said.}The trip was 5 hours and I made it on three separate occasions.I apparently must be slow minded,but I now realize that everyone is just covering their arse,and no one wants to mess with a surgery they did not start.All of you out there living with a failed lumbar fusion-PLEASE-share your experience.Research shows that the second time is not the charm.How do you cope with your symptoms?When do you stop questioning and accept?


  • So basically you cannot get a second chance to fuse? That is pretty messed up.
  • I am always surprised when I hear these stories because it is so different from my experiences! I've not had trouble finding any number of surgeons who were willing to go back in and try to make things better.

    I assume you are not trying to blame the surgeon for the non-fusion, right? People don't fuse for a variety of reasons, most of which have little to do with the surgeon. I don't know if the surgeon who did the other surgeries is an orthopedic spinal specialist, but that's who I would suggest going to. At least according to my doctor, they are less "fussy" than neurosurgeons.

    Sometimes you have to just keep trying until you find someone (a well-qualified fellowship-trained spinal surgeon, of course :) ) who is willing to take you on.

    I really am surprised you are having trouble finding someone. At least from the information we have from your post, it sounded like a fairly straight forward surgical procedure -- you don't need a six level fusion, or something, right?

    I think there are still a number of people on the board who have had second fusion surgeries. I had a PLIF at L4-5 two years ago with rods, screws and a cage. In a month I am going back in for what will end up being a 3 level fusion. He's going to remove the rods from the first operation, and put in two continuous rods that will run from L3 to S1...so, it's pretty much like redoing it. He'll go through the same incision, etc. It is a different surgeon than who did the first fusion...

    Usually if one hasn't fused the first time, things are done slightly differently. Maybe a different bone product is used to enhance the patient's own bone. A bone growth stimulator is often used, etc.

    Don't give up. Obviously I am not a doctor, but it would seem that a second attempt at fusion would be the way to go...before having to resort to permanent pain management. Keep trying. Perhaps a large university teaching hospital would be the way to go....

    Good luck. Let us know what happens.
  • I had a fusion and was doing very well for almost 2 years when something happened at work and I started to have tingling down my leg to the toes. I called my surgeon ( who I had seen for a follow up 5 monthes earlier) and he had moved! I could get an appointment with one of the 2 newest surgeons in the group but it would be a couple of months before I could be seen. So I went to another Doctor who said it was muscle sprain. I finally got to see a surgeon a couple of months later who said the Doctor who did the fusion did not place 2 of the pedicle screws correctly and 1 was hitting a nerve. He recommended removing the hardware. I went for a second opinion and he saw the same from the ct mylogram, but also thought the fusion did not look great. So he is going to remove the hardware next monthe and may add bmp to the fusion area if it does not look strong. I had the origional surgery minimally invasive, but this one will be open so he can look at the fusion. He said I would be in the hospital longer than the origional surgery, and will be wearing a back brace again. I would keep looking for another doctor to help you.

  • I hope you keep looking as I had a failed fusion L3-L5. This time the surgeon used the lab created and my own bone again and removed old hardware and replaced it with more that now goes into my pelvis. I wear an external bone stimulator 4 hrs a day. It looked like I am beginning to fuse on my last xray. Though I still have pain and right leg numbness and r foot radiculopathy. Some times I could just scream from the discomfort and my husband does not understand. I still use pain relievers 1-2 times a day, depending on what I do. So please keep looking , you do deserve to have a stable spine.

  • Thanks for your feedback. I really need encouragement right now.I am going to keep trying.I was "kicked out of PT Tuesday,as the therapist noticed a remarkable change in my right leg strength.He won't work on me until I see a neurosurgeon.It's almost getting comical.The PT was very helpful,keeping me mobile and decreasing some discomfort.I don't waste my energy finding someone to blame.There are always going to be surgeons willing to operate-but I am picky about the candidates.Has anyone had any luck with a second fusion.Don't be shy-I can take the truth.I have seen some very fashionable canes.Reality is easier than the constant merry-go-round of half truths and false expectations.I have spent 5 months just looking for someone with the mind[being polite] to tell me the truth.I am too young and healthy to not keep working for an answer.Thanks again for the help
  • Janeellen,
    Accepting seems to be a dirty word when it should not be, many choose to chase that expected remedy in the hope and expectation we should all give ourselves the opportunity to do the bests from every point.

    If we go with the adage that it must be fixable that drives us to continue to seek our the idea of surgical intervention and the panacea to all our ills, that may well be productive for some and having had a failed fusion we are more pronounced in the idea that a similar process may be equally ineffective.

    As the recipient of any surgery we then go into the next process as a uniquely changed individual and I do not have the statistics that would give us some guide as to how effective second and consecutive surgery may be on us in the future. It is not something we can retract and we have to live with the consequences either good or bad with managed regret if required.

    As you say, blame is a corrosive and a historic reflection, it would be far too easy to blame others on my failed condition that in reality always had some chance of failure, no amount of angst will change the nature of my symptoms or how I am imposed to survive.

    You have to decide what benefit your would gain from additional surgery and could you live with your condition as it is if you had too, it is understandable for us to think of what may happen and that has to be a measured possibility and not expanded into any more than realistic negativity.

    Knowing when those proposals are more rhetoric than reality is always difficult and only we should decide when and where our stopping line is.

    My professor told me the truth as sad as it was, he looked me between the eyes and said you are going to have to live with this condition, others more adventurous wanted to open up my chest are go on some exploratory adventure. If someone said this could be your life how would you accept or adapt to that, I have had my condition 20 years and the proposed restriction slowly coming to fruition. It is not negative to face reality and unburdens us from all that illusion and talk of potential improvement, they are saying what we what to hear and they know it, not what will happen.

    The truth is I lost my job and had three young children, many things I cannot do and I can also do many things I never imagined, I may never catch the healthy individual that was me of the past or even glimpse any sight of the person I was before.

    Accepting is empowerment it puts that responsibility of managing every day at our own feet, gone are false hope, expectation and the notion that for just some extra effort a solution was always around the next corner. The older me is inside, I am wiser more focused, I know where I am going and what tools I need on the journey.

    I as you just wanted the truth, I did not have to like it.

    Take care. John

  • Is it the L4-5 surgery where the bones did not fuse together? I think there are still some people on the board who had one fusion that did not work out. Then the surgeon, or a new one, went back in and redid the surgery. Often, the second time, they will go in from the front and the back (which is the way some surgeons approach the problem to begin with). This way, it can be reinforced from one side and rods and screws can be used from the back side.

    I can tell you my story, which is a bit different but it is the same in that my two surgeons each, independent of one another, told me there was no more surgery to be done on me. I was told by each to try a spinal cord stimulator.

    Due to the nature of my pain, I did not believe that it was time to try the SCS, so I was tenacious in pursuing a different answer. I suppose most people would have at the very least changed surgeons. But I feel my second surgeon (who did not do my PLIF at L4-5) is one of the best in the area, and I gave him a chance to bow out if he did not want to continue on with my case. He assured me that was not the case, so I just kept making an appointment once per month and would go in and ask him what we were going to try next.

    I had a variety of diagnostic nerve blocks. My alternate medicine guy that I go to kept assuring me I had an instability issue, as did the physiatrist that does the injections...so I kept pursuing it. Eventually I convinced my surgeon to let me have a positional MRI, a procedure that is not available in my city. (Many spinal specialists do not put much credence in the positional MRI. The last neurosurgeon I went to for a consultation would not even look at that film...dismissing it as "gimmicky" when I inquired why.)

    Anyway, I won't go into more detail, but the bottom line is that in two weeks I will be having a 3 level fusion from L3 to S1. I now realize that what both doctors were saying a year ago was that they did not see any reason to justify operating on me again. There was nothing wrong with the fusion at L4-5 and there was no nerve compression showing up on the standard MRI. Ethically they could not justify another surgery.

    What has changed is that I was able to prove to surgeon # 2 that there are signs of instability which is compressing the S1 nerve whenever I am on my feet.
    And now he can justify to himself, to me and I suppose, to my insurance company, that surgery is warranted.

    My point is that your surgeon may be saying the same thing...although he should be willing to meet with you and explain how things stand. Since you did not fuse the first time, why is he unwilling to perform a second rescue surgery? What is the reason?

    It seems to me, from what you've said, that at this point you do not have enough information to know if you need to accept what has happened and move on to pain management, or if you should continue to pursue a surgical attempt to resolve the issues.

    Do you have another doctor, like a PCP that you are working with? Perhaps another doctor could talk with the surgeon to get the information you need to know how to proceed. Only you can decide when it is time to stop pursuing a surgical option, but it seems to me you are far from that point.

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