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Autofusion versus surgical fusion

Hey there everybody. I was wondering if anyone has chosen to let their spine fuse itself versus a surgical fusion? My docs say my spine is working toward fusing itself. I have lost considerable disc height from L3-S1 with developing stenosis and ddd. I am only 35 years old and have been fighting this problem for over 12 years intermittently, daily for over 18 months now. I was offered a referral to consult with another spine surgeon, but I have declined. The last 3 surgeons won't operate because of my age. I am wondering if an Autofusion is preferable to a surgical fusion and if anyone has any experience with an Autofusion. Thanks for your help!
Candace
DDD & spinal stenosis L4-S1 since 2001
30+ injections, PT, massage therapy, accupuncture, TENS unit, meds, etc but no surgical intervention
I am not a surgical candidate
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Comments

  • RickilalasRRickilalas Posts: 559
    edited 05/07/2013 - 2:04 PM
    Hi
    I can see the people saying what right now but it does happen when the body tries to protect itself .
    I had L4, L5 and S1 fused in 2007. Last year the CT showed that three almost evenly spaced bone spurs reached down from L3 to L4 and attached. My surgeon said it saved me a surgery as long as the bone growth stops and nothing like nerves get in he way. But waiting on that to happen could be a bad idea.
    If you read much on the forum it does not take much time to find people that waited to long for surgery and ended up with nerve damage that is not repairable.
    I had the bad back for years and years all they did for me was pain meds and muscle relaxers..
    After about 20 years of this they finally said I needed surgery and then everyone asked why I waited
    So long to do anything. I am dealing with many damaged nerves now. I can't see if they had done a surgery years ago why it would have a negative effect on me now. With the levels fused I still have enough range of motion to deal with life. Its the nerve damage that's hard to deal with.
    I Would get another opinion and make sure they are not connected in anyway to your doctors now so you get a true opinion and not somebody else just reading what's in your file. I would see a new spine surgeon with my scans and X-ray but let him tell you what he thinks before you say what your doctors told you.. Just my thoughts .

    Rick

  • Rick,
    Am I correct in thinking that you waited, and your vertebrae had self fused?
    If that is right, when you had the surgery, was it more complicated because the surgeon had to seperate the self fused vertebrae? Why did you end up needing surgery if you had already fused?

    My surgeon has pointed out on my post surgery x-ray that the two levels below C3/4/5 where he did the ACDF, are now self fusing, or have already fused. This makes me wonder what will happen in the future. Will I just lose mobility as I will have four levels fused? I do worry that nerves may get compressed by the growing bone and then I will need another surgery. I would imagine that it would be more difficult to break/cut the vertebrae apart to open up the spine canal and foramen to get the compression off the cord and nerves.

    As I have a congenitally small canal, I don't have much room to play around with!
  • First, I would never accept an "age" issue. I was 32 when they did my spinal revision... wanted to do it at 31 but I refused... as a teacher I wanted to wait on summer. So get some more opinions... age shouldn't be a qualification... either you need surgery or you don't.

    Second, in my opinion (and my opinion only).... it is difficult to correct a fusion. My fusion had to be broken in several places, and parts removed (in triangle shapes) to stand my spine up correctly. I had no "complications" as in infections/side effects, etc... and still spent 10 days in the ICU (5 weeks total in a hospital) due to the stress it put on my body (a relatively healthy 32 year old).

    Best of luck, get lots of opinions, and go with a doctor you feel like you can trust. I always looked for a doctor that FIRST wanted to improve my quality of life and second my spine.
    33yo mom of two. My surgical history...preadolescence scoliosis, kyphosis, and a hot mess.... 5 spine surgeries and lots of items added I wasn't born with (titanium, peek, surgical steel). Guess cremation is out. TSA loves me.
  • Candacewi5
    I agree with Allmetal age should not be a issue small kids have spine surgery when needed.
    The problem I would have with allowing such a large area to self fuse would be all the issues that could be entrapped in allowing that. My guess is that you would have nerves and other tissue get in the way which could effect you severely with such a large area. I would be looking for spine surgeons that do surgery on some one your age. If you wait how much damage will or might be done before the fusion is complete. I do not understand them saying you should wait because if it does fuse and isn't right it would be a night mare to fix. I also believe like All metal does that a poor fusion would have to be cut apart to be fixed which that alone could cause some serious issues. In my mind I would not wait.

    Jelly Hall
    A brief history on my surgeries
    2006 ACDF C5,6,7. Six months later I needed laminectomys of that same area from the back side.
    A MRI was done showing my cord did not have enough room plus that's when I found out I had cord damage at C6,7

    That six months took me into 2007 and they did the laminectomys plus I needed to have lumbar fusion of L4,5,S1 . Like a idiot I begged my doctor to do those on the same day. Big mistake but it worked out.
    MRIs in 2009 showed bone spurs starting to grow from L3 and L4 then I had then I had SCS unit implanted. About two years ago, I need to look up date for sure I had CTs that showed fusion of L4 and L4. My last surgery for two nerve root compression of the same area showed the doctor I had three well formed spurs that grew from vertebrate to vertebrae making a good solid self fusion of the L3,L4 area.
    He said it was rare because it was even and well done without causing any damage to anything else.
    I had no idea and have not lost any range of motion from any of the lumbar fusion.
    It just happened to turn out well for me and save a future surgery for that level when it degenerated.
    Some times the body is pretty smart now I need to wait and see if the bone growth stops or it may cause another issue later.

    Rick
  • Thank you everyone for sharing your experiences. The more research I do about auto fusion the more concerned I become about it. My last surgical consult was over a year ago and I will schedule one for this summer. I found a great surgeon with a spine center and I hope she can offer some type of plan instead of just telling me I am too young to have a spine that looks like this. After reading information here it seems to be a cop-out phrase. I have been extremely reluctant to do surgery because of the down time and recovery process. We live in a very rural area, I have 2 grade school aged children, my husband works 50-55 hours a week being the sole provider for our family, and we have no support system outside of being self reliant. I also see a lot of times that surgery can either not correct the problem or fixes one problem only to cause another and that is very frightening.
    Candace
    DDD & spinal stenosis L4-S1 since 2001
    30+ injections, PT, massage therapy, accupuncture, TENS unit, meds, etc but no surgical intervention
    I am not a surgical candidate
  • So much info. All I can offer is my own experience. Like everyone else here I have been in constant pain for many years. It was discovered during one of my surgeries that three of my vertebrae herself fused themselves. I was unaware there was an issue with them because I had ignored the pain. Surgeon said I w lucky that they had fused in line and no nerves had been damaged. I did lose a little mobility and almost 3/4 inch in height.

    Good luck whatever you decide.

    Larry
  • jellyhalljjellyhall Posts: 4,374
    edited 11/14/2013 - 6:27 AM
    So I assume that your surgeon just left the self fused levels alone?
    I wonder, with time, if things will stay the same or if more bony spurs will grow that could cause a problem.
    Perhaps if movement is stopped by the vertebrae growing together, no more bony spurs will develop.

    I keep meaning to measure myself to see if I have grown since my 2 level ACDF with cages.
    I grew over an inch after my lumbar fusion. :-)
  • Wish I'd thought to have them add a little of my height when they put my cages in ! My auto fusions were discovered in 1993, we left them alone and its probably the only part of my spine that I don't have trouble with.

  • That is encouraging that you haven't had any trouble with those levels and they were fused in 1993. :-)
  • grandmesamomggrandmesamom Posts: 182
    edited 05/29/2013 - 4:40 PM
    I had a long history of back pain that I did not seek treatment for.When I was 34 the pain was so bad that I did seek treatment. Long story short I had a large area at l4 and l5 that auto fused.I also had spondylithesis and a herniated disc.I had a spinal fusion at 35 . I also had three young boys ages 2,6 and 8.it was tough going but we survived.I made it a game for the kids and they were helpful.The surgery did help greatly and relieved my severe pain. fast forward by the age of 50 I have severe spinal stenosis and have been advised surgery by two Ds again. I know I have nerve damage and leg weakness but I can't bring myself to say yes yet.Like I told the neurosurgeon does one surgery always lead to another? good luck it's always a tough decision.I think I waited long before I sought treatment but age was never mentioned to me .
  • RickilalasRRickilalas Posts: 559
    edited 05/30/2013 - 9:51 PM
    In many cases waiting may be a good idea waiting to long may leave you with nerve damage that will never ever be repaired its a tuff choice and only you can decide.
    I do not believe one surgery brings on another because of the surgery, I believe the next and the next surgery needed is because the spine is giving out and need help.
    I waited to long I have damaged cervical nerve roots, cervical cord damage which has no repair and lumbar nerve root damage plus nerve damage away from the spine.
    Always get a second or third opinion and go from there.
    Permanent damage is hell to live with and it can cause so many more issues with stuff like bowel and bladder. Be smart but be carefully. Kids always seem to like to be involved and help it makes the feel important and they are.

    Rick
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