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when do doctors call a fusion 'failed'???

achyneckaachyneck Posts: 163
edited 06/11/2012 - 7:57 AM in Back Surgery and Neck Surgery
I had a c1/c2 fusion (my bone from hip and 2 wires) in the beginning of April 2011. Surgery was needed due to a bone spur causing atlantoaxial instability, muscle spasms, hand and foot numbness, and numbness on the back of my head. After several weeks postop-, the muscle spasms subsided and I began PT. I walked 2+ miles a day and did 2 hours of PT 3x/week. The pain never went away completely, and at 6 weeks post-op I was in continual pain again, and it has only gotten worse. About 5 weeks ago (5 months after surgery), I was prescribed a bone growth stimulator. I wear it 4 hours a day religiously and my pain has not subsided at all, and now the numbness in my hands and feet has returned, worse. My feet get tingly if I stand up for more than 3 hours, my arms go numb at night sometimes, and the other night my right hand was trembling when I was eating dinner (I guess my fork was too heavy!) The pain is unbearable.....I want my life back. I have an appt with my surgeon on Nov 8th, but plan on calling him tomorrow. So I guess my question is 'How long do surgeons wait until they consider a fusion as failed and redo the fusion using a different method?
any and all advice is GREATLY appreciated!
Monica
April 2011 C1-C2 Fusion (Brooks wiring)
January 2012 C1-C2 Revision Fusion (Harms Technique)
2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
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Comments

  • First off, you might want to try and keep your post in one forum vs two or more (we're not suppose to duplicate. :) Just friendly advise there.

    My surgeon put me on a bone growth stimulator around 4.5 months when most of my pre surgical symptoms (and them some) came back. I saw what looked like a crack at the top of my fusion from the x-rays he ordered around that time as well. When I pointed them out, I was told it would 'resolve' over a year or so, and not to worry about it!! I felt basically blown off from him that day. My hubby didn't agree for almost a year later when it was clearer in CT's and X-rays.

    My body kept telling me all was not good. (that was my C6/7 fusion). I saw several Neurologists, and they told me that more likely than not a surgeon would want to revise and too add a level or more to stabilize the fusion. Still wasn't told my fusion 'didn't happen, or failed.' Little did I know that the 'crack' I saw (and was blown off over) was the beginning of what is called a pseudarthrosis (false joint as the fusion had indeed failed). I was still blown off each time "details" started to emerge.

    A dear friend on here convinced me to seek an Orthopedic spine specialist who specialized in revisions or complex spine surgery, as also too, it looked more and more like I had bone issues causing neurological problems. I found a wonderful one, and he was totally blown away at how many missed what "a blind man wouldn't" in so far as the fusion failing (failed - never really fused period), and too the resulting instability in my cervical and upper thoracic spine! I ended up having a 5 level fusion from C4-T2 and too laminectomies from C4-C7 to free up my spine. I also developed what is called "Myelopathy" of my spine. In basics the pathology of the spine, damage due to impacts at various times from daily activity over a 2 year period, and thus was diagnosed with it, and 'incomplete spinal cord damage."

    If you are feeling 'things' aren't right, I would seek out a specialist (Neurologist or Orthopedist) that specializes in the spine to get fully looked over to be sure all is well, or maybe you sustained damage before the surgery, and it is still there - answers are the key! They then might recommend you see a spine surgeon if needed. Listen to your body, and don't give up until you have answers one way or another.

    Hopefully further surgery isn't needed, but (good or bad), better to know what is fully going on, if at anything, to put your mind at ease! Please let us know how it goes. I hope all turns out well for you. Fingers crossed you didn't have a fusion failure.

    Ps... many on here don't get told they have a failure (at least for the cervical) until a year or so, some sooner of course. Mine was best seen between and x-ray (lateral, extension and flexation), and too no question when a CT was performed. The CT is a super x-ray that most times will see the full status of a fused level.

    Please remember, my information is based on the experiences I myself went through that might be of help to you. Gentle support *HUGZ* for you and what is going on.

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Monica,

    I think the when you get told all depends on the symptoms and the films and how clear it is to the surgeons. I had a failure at 5 months post-op. In my situation it is was psudeoarthrosis and was very clear on plain images, the surgery had failed. Like you I had bone from my hip along with wearing the bone growth stimulator, however mine was order the day after surgery. Like you the symptoms were back fully in that time frame as well. Luckily my surgeon didn't have to go to much work to find the issues as they were very obvious. Good luck and keep us posted on what you find out, If the symptoms are getting that bad please call your surgeon as they may want some test, such as a Ct scan, ran before hand, and can give you the results on your appointment.
  • I would think right about now they can see if you fused solid or not. If you had it done in april that puts you about 7 months. Unless it takes longer the fuse, in some cases,

    It can be a very painfull process to totaly heal, hopefuly it will work out for you, Good luck,
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • @Brenda, I didn't mean to post in two places. I didn't think my previous post from a while ago addressed that question. I just thought I would ask under the surgery forum if others had experience with nonunion, and how long their doctors waited before declaring it and offering a 're-do' :)
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • @achyneck,

    Hehhehe..no problem, looks like a mod saw it too and took it out.

    The key though remains, "When does a doctor decide." I know for mine, I ran into doctors (surgeons) that didn't want to work with my failed 'landmind' so I was blown off in the hopes I would go away. Instead of feeling fully blown off, I took it as reason to keep digging for the truth.

    Let your body tell you, I know mine has been spot on. If you don't feel they aren't addressing your symptoms, or concerns, keep looking for a surgeon (neuro or ortho) that is comfortable with revisions or complex surgeries. I know for me, so far all is working out well finally. Please let us know how it goes.

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Met with my surgeon today and my graft is resorbing, so he referred me to another surgeon more skilled in cranial surgeries at a University. Surgery will be likely within a week.
    Keep your fingers crossed for me!
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • achyneck,

    Ouch (surgery), but so glad to see they do know what is going on. Sorry to hear of more surgery, but for sure will keep my fingers crossed for a great outcome!!

    Thanks for the update. :) *HUG*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Thanks Brenda! I am still dwelling on it...pretty freaked out about drilling screws into my C1 so close to my cranial arteries....it is a scary surgery. Plus, I don't really have 'time' for this right now LOL. 2 kids, my dog just had 7 puppies (chocolate labs) and they are 4 weeks old, my mother-in-law (who lives with us) had her spleen removed due to lymphoma and starts chemo in 2 weeks, and trying to nold down a full time job as a biologist! Not to mention being in pain 24/7.....I'm losing the battle!
    thanks again,
    Monica
    April 2011 C1-C2 Fusion (Brooks wiring)
    January 2012 C1-C2 Revision Fusion (Harms Technique)
    2010 - current: Trigger Point Injections, Epidural Injections, Bilateral C2-C3 Radiofrequency Ablations
  • Monica - Pretty name btw!! :)

    Is *any* surgery the right time, or that we have time for it? (smiling with yours)

    I'm happy for your litter - sounds lovely, it really does. Hopefully mom is a good mom. Do you have buyers for them? That for sure helps if you aren't into keeping them.

    As for your mom in law. Nice to see she has support of you guys. Sorry to hear what she is going through, can't be fun for her for sure. Well wishes heading her way!!

    I am not thrilled my levels (2 with disks left) above staying the game. I foresee in the future (hopefully waaayyyy into the future) they hold the course as they say. I'll keep fingers crossed for us both, your cranium, mine levels. How's that for a buddy deal? *wink*

    Brenda
    PCTF C4 - T2, Laminectomies C5, C6 & C7. Severe Palsy left arm/hand.
  • Monica,

    Sounds like your in for a rough deal going back through surgery. The good and bad is you know your body and something was wrong, and sounds as though it has been sorted out pretty quickly for you. Obviously the bad is taking the risk of doing another surgery, along with the recovery itself. The good side is that with surgery, hopefully once recovered you can function better in what sounds like a rather busy life style. Sorry to hear about your MIL, but maybe with surgery, and you being at home recovering you can spend more time with her and even if it is just emotional support. Have a family member going through chemo and radiation right now, and the emotional support is so important. Prayers for you, MIL and family that all of this will get better and you'll all stay strong during this difficult time. Be sure to keep us updated on how you both progress and when your surgery is.
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