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Failed Spinal Fusion

I had spinal fusion on L4/L5 with bone graph and cadaver bone. I'm almost 3 months post op. While I feel better I still have pain and have muscle spasms. My Dr. said my fusion is not fusing . My hardware is 4 screws and 2 rods. I did smoke until weeks b4 surgery and quit..well I started back (5 cigarettes a day) . I have tried so hard ...Chantix made me go crazy... I am addicted terribly to nicotine. I'm very active and have been since 2 weeks after my surgery. I walk 3 miles daily, cook meals , do laundry, mow the yard, clean the pool , do all grocery shopping and swim. I don't take prescription pain meds only Tylenol Or Naproxen. My dr. refuses to give me any muscle relaxers. He told me if there isn't any progress in the fusion by my next office visit ( next week) that I will have to have another surgery to add more hardware. I've started taking vitamin d 3 and calcium daily. Needless to say I'm scared to death. My dr.is very intimidating. I'm 48 yrs old and in good health except I had my thyroid removed at 18 due to thyroid cancer.and do take thyroid medicine daily. Is 3 1/2 months long enough time to see a lot of results or fusing???
Susan ;)


  • ADRJenAADRJen Posts: 211
    edited 07/03/2014 - 2:28 AM
    I wasn't fused at 3 months either, but at 6 months I was. Also, I think you may be a bit too active. Until you are fused, mowing the lawn, cleaning the pool, etc. (and of corse smoking) could jeopardize your recovery. Just saying.
    Artificial disc at L5S1 for 10 years. Had 3 Level lumbar fusion and Laminectomy on Sept 27, 2013. It was an OLIF (Oblique Lumbar Interbody Fusion) with cages, BMP, rods & screws. Norco, Plaquenil
  • Unfortunately, you've had a surgery not using the latest fusion techniques. why didn't they use a cage and bone growth hormone ? My posterior L5 s1 fusion was visible on xray after 3 months. Same hardware as you. However I was not as active as you describe, my standing/walking limit was almost exactly 30 mins for about the first 4 months. I did some swimming after about 8 weeks. Biggest help was reformer pilates for my core.
  • Following the post op instructions is just as important as the surgery itself. You can have a successful surgery but if you overdo it during the recovery stage then it can cause complications. I would slow down and limit your activity. Walking is good but I would talk with your surgeon about you restrictions.
    Progressive DDD
    Chronic S1 Radiculopathy
    Discectomy L5-S1 2002
    Discectomy, Laminotomy/Foraminotomy L3-S1 January 2014
    Bilateral SI Joint Fusion and 2 level spinal Fusion October 2014
  • sandisandi Posts: 6,343
    edited 07/04/2014 - 7:27 AM
    but one of the big issues is the smoking. No matter how many cigarettes you are smoking, smoking and it's chemicals prohibit new bone growth.
    And adding to that, not following the post op restrictions can cause the grafts to dislodge from where they were placed, and contribute to failed fusion as well.
    That no bending, lifting ,twisting, and activity restriction to short walks, several times per day are to help you and your body recover from a major operation.
    There are other medications that can be used if Chantix doesn't work for you, zyban is one that I am aware of used to treat nicotine withdrawal, and there are patches, but those contain nictoine as well.
    The surgeon may opt to use a bone growth stimulator, but at this point, it may or may not work at this juncture.
    The operation is the easy part, the hard part comes post op, when we want to resume our normal lives prior to the injury that put us needing surgery in the first place. Resuming too much activity, not following the post op restrictions and follow up leads us to having more problems down the road.
    I hope that your surgeon can come up with an idea to try to get your fusion to take, without having to redo it, and the biggest things that you need to do, is 1. Quit smoking, in any form, and 2. Cut back on the activities and stick with the post op protocals until you are released to resume those activities.
  • Taking pain medication can mask the signals from your body that you are doing to much also. With a fusion I can't imagine how you can be that active after so little time. I took Tramadol pain killers which made me feel 100% even a month after surgery.. amazing stuff.. but its dangerous because you can push your back too early in the recovery. Sounds like smoking will massively extend your recovery time.
  • Please quit smoking!
    Talking from past experience at just 22!!
    I smoked through my pelvic surgery when I was 17 and I had trouble with it healing, I got an infection and it took my bone so long to start growing and fusing. I quit smoking when I learnt I would be going through surgery again but my surgeon would not operate until I was smoke free for atleast 6 months. I am now 6 weeks post op for a L5/S1 fusion with similar metal work and they can already see signs of healing and growth.
    I'm not anywhere near as active as you were I'm only doing 1 walk daily which is done by house numbers (advise of my pt) and never is the same everyday sometimes further sometimes shorter. I have physio once a fortnight and I am starting weekly hydrotherapy from yesterday. I have been advised against doing laundry or housework due to the strain it puts on the back so luckily I love with my mum and she's a massive help but I know this isn't the case for a lot of people. I tend to do 30 mins sitting, 30 mins standing or walking and then laying flat on my back in between which I have been advised to do until 3 months.
    I hope this helps but please try to quit even 1 a day causes huge problems after surgery with the healing process and leaves you open to so many nasty things!
    Good luck keep us updated :)
    Pelvic fixation 2009, L5/S1 fusion 2014
  • Guys it's such a addiction smoking. Easy for you all to say quit. Even with my 4 level I could not kick the nasty habit. I have not had my year X-ray but hopefully everything is okay. Susan M my advise would be to cut back on the extra activities and do the best you can about smoking. I had a PCDF from C3 to C7. I also wore a bone stimulator for 9 months. I know how much anxiety quitting smoking can cause. 5 smokes a day seems like you are getting it under control. Keep up the good work but slow down, maybe you overdid your limitations. I did stick to that and 1 year later I still have many limits. I also had a collar on 24/7 for a solid 3 months and the had to wean off, then intensive physical therapy. I'm still going to therapy. From Oct to Dec. then chiropractor, now physical therapy again. It just takes time.
  • it's far too early to say your fusion has failed it can take over a year FACT to fuse I also smoke and smoked on the day of my operation {stupid I know ] but my consultant {also a smoker] told me that I will make no difference to the fusion the chances of cardiovascular problems are increased ..but as a smoker ..we know that .back to your fusion what makes you think its failed ? are you still in pain ?? because a fusion won't always cure pain ..in fact it hardly ever does fusions are done for spinal stability .give it more time .if you have any leg or foot pain or problems that were there before your operation its a good chance that they will still be there after your op .but if your leg and foot pain where does during your op there is a chance that it will go away {it can happen during surgery } especially with an inexperienced surgeon .ALIF is about the worst to recover from and can take upto 3 years to recover from ..my ALIF has been a technical success but I am still in awful pain but that due to the damage to the nerves from previous surgery to my spine by inexperienced surgeons .take care and I hope things settle down
    1997 laminectomy
    2007 repeat laminectomy and discectomy L4/L5
    2011 ALIF {L4/L5/S1}
    2012 ? bowel problems .still under investigation
    2014 bladder operation may 19th 2014
  • backache99 said:
    it's far too early to say your fusion has failed it can take over a year FACT to fuse I also smoke and smoked on the day of my operation {stupid I know ] but my consultant {also a smoker] told me that I will make no difference to the fusion the chances of cardiovascular problems are increased ..but as a smoker ..we know that ....{UK}
    Tony, actually it is my understanding that smoking does impede bone growth and hence can prolong the fusion process, so it really is recommended that patients give up, appreciating that it is very difficult but the benefits are, in my opinion, huge. I found a section on this site about this, hopefully this link works;

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