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When did you know you were finally fused? Or not?

optimistooptimist Posts: 546
edited 06/11/2012 - 8:19 AM in Back Surgery and Neck Surgery
I know everyone is different, but when did your surgeon announce "You're fused" and show you your X-rays? I had an ALIF in February, and my surgeon said "we typically don't start to see anything on X-rays until 6 months". But, I've talked to several people that were told & shown on X-ray they fused at 6 weeks, 8 weeks, 12 weeks etc.: fluffy/cloudy stuff first, then streaks, then solid white. I saw the papers in the Spine journals w/pics of the X-rays, the studies on BMP and what the success rates should be for single vs. double-level fusion at 3 months and 6 months post-op.

I don't want to confront my surgeon, but I've got a gut feeling I'm not doing well and not fusing. For those of you that didn't fuse: when and how did your surgeon break it to you, and if you were still in life-altering pain what did you do next? I'm trying to stay positive...but losing faith daily.

Thanks to all for any input.



  • It depends............. I have seen people here that fused in 4 weeks and others that after a year are not completely fuse, it all depends. I am sure that your surgeon will share with you when you start fusing. Remember, patience pays! ;)
  • Hey Optimist (that is a good name, keep it, live it!)

    I posted that same question on the old site when after my 6th week checkup the Xray did not yet show fusion but my surgeon reassured me that he does not expect any at least till the 3-months checkup - or later. The responses I received varied greatly, convincing me that I just have to wait out my sweet time. I assume if no fusion is taking place, say after a year or so, the surgeon will discuss that with me. I assume your surgeon would let you know too if he thinks you are not fusing after a reasonable amount of time. So we just have to be patient, and keep on walking and hoping.

    Good luck,

    Kin :) ;) :) ;) :) ;)
  • On Monday and I'm 7 1/2 weeks post-op that I'm fused and I saw it for myself. It looked like threads through it at 4 weeks and at 7 1/2 it was pure milky white bone! It was a beautiful thing, now if they could figure out why I'm still hurting!

  • Optimist,

    I waited 10 months before I found out if I was fused or not. I did the xrays prior to that, but was told fusion could not be confirmed by xray. I had all the signs of fusion while I was waiting for the word, but there's nothing like seeing a 3 dimensional image of your spine from a CT scan. That is the only way my doctor will confirm that a fusion is complete. He only uses the xrays to verify that the screws have not moved and everything is in the same position. I just had my first xray since my hardware removal yesterday and if it had not been for the ct scan and my doctor visually verifying my fusion you would think that I am not fused at 1 level.

    Be patient, it takes time for this process to take place. Think how long it takes for a broken leg or arm to heal. Now replace that thought with growing bone over a larger area where no bone ever existed.

  • My doctors pronounced me fused at 7 months.

    Emergency surgery in March of 2006 for spinal infection of L 2 and L 3. During surgery, discovered I had Cauda Equina Syndrome. Spine became unstable after surgery and had 360 fusion with 10 pedicle screws, plates and rods in April of 2007.
  • I had x-rays at 6,8, and 12 weeks at my previous fusion.. still no bone growth; but, the NS never told me that i wasnt fusing. A year later, i was still having an ungodly amount of pain in the lower back, still wasnt able to move like i should, and was feeling worse than i did before the fusion. I went to my PCP, he referred me to a different NS; he did bone scan, ct scan, and x-rays; low and behold, i didnt fuse at all ( at a year and 1/2).. gee doc, thanks for telling me that..jerk... so i just had my 2nd fusion and doing better this time than i ever did after the 1st.. so hopefully ill have better results than i did the last... god bless and take care
  • I am about 20 weeks out of a posterior cervical fusion C2-C5....I think that the doc said that I am fusing. Oh course, I have no clue what "fused" looks like on an x-ray. I had X-rays at 6 weeks, 12 weeks, and then had a CT scan and MRI scan last week because they were checking for the regrowth of the tumor, the problem that caused me to get fused in the first place. I know that I am different in the sense that I had a cervical fusion and not a lumbar, and the fact that I am missing half the bone so I have 4 screws on one side and only two on the other, but I know how hellish a fusion procedure is. I am still in severe pain even though I am fusing and that kills my spirit everyday. I needed my fusion to save my life though - so I guess pain is better than death.

    To go back to your original question, I would say that it depends on where the fusion is and the person. I am 19 and had a cervical fusion and am still not 100% there yet. It takes time....and it sucks.

    Good luck to you and everyone!!

  • Hey Dave,

    You mentioned that you had shown signs of fusion before the X-ray actually had shown anything. I am curious, what are these signs? I thought that the only way to make sure one is fused is through X=ray. MRI or CT scan.

    Could you answer me?


    Kin :)
  • Wow, there is a huge difference in what we have been told. Here is what I have been told.

    2 different surgeons have told me that the x-rays are taken to check the hardware (like Dave said). They want to make sure that nothing has moved. I have been told that at 6 weeks it is way too early to confirm whether one is fusing or not. Bridging typically occurs first (I'm told up to 3 months), and then the ossicifcation process will start to fill in and make the fusion solid, taking a very long time to be complete.

    At 9 months post op ACDF, we could not see any evidence of fusion on the x-rays. This caused the doctor to be suspicious and he ordered a CT scan, explaining to me that there is no way to tell for sure on an x-ray. We proceeded to have the scan and sure enough, no fusion. The doctor wasn't too worried and said there was still time, and that the fusion process can even take up to 2 years to complete, but that at one year you should see some good progress with it.

    I ended up having a revision due to non-union and other symptoms, and this time they used my own bone ground up and inserted into a cage. They then added bmp. I am now 8 weeks post op and had x-rays a couple of weeks ago. When I questioned whether he sees anything, he said that it is way too early, and that he would be surprised if it were to show anything this soon.

    Maybe lumbar spine is different from cervical. I would suggest that you just be patient, eat lots of good nutritious foods, take a calcium supplement with vitamin D, and check with your doctor to see if omega 3 is good in your situation. Protein is also good for growing bone.

    I wonder if a surgeon will tell a patient that they are fusing, meaning they are starting to fuse. I am sure there are different variables with everyone, but from everything that I have read and been told, complete fusion does not happen for a very long time.

    Try not to worry yet, you are still very early in the recovery process.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • Kin,

    The signs were from xrays. You can see the area getting cloudy, or blury, or whatever. The problem with xrays is that they can't determine if the fusion is solid all the way through. It takes time for everything to fill in and become solid. IMHO, a lot longer than 4-6 weeks. It takes that long to heal a broken bone. I have a hard time believing someone can fuse in that short period of time. I think some of these doctors are jumping the gun. I would love to here one of these rapid fused members ask there doctor to remove their hardware at 6 weeks post-op if they are so fused. If the surgeon is willing to remove the hardware, then I'll reassess my position on this subject. Until then, I'll stand by the industry standard that it takes anywhere from 6-12 months to fuse (in some cases longer than that).
  • Have any of you heard of away to speed up fusion!! Like taking curtain supplements, stretching, exercises?? Or those of you that fused so soon what did you do prier to fusing??
  • What is the difference between "non-fusion" and "non-union" - aren't they the same thing? Thanks,
  • 6 1/2 months and not fused
  • You sound like a wise man. Ya, I bet asking the doc to remove the harware as soon as he declares one fused would be an interesting test to see if he really meant it. But wouldn't it be scary, if he would actually want to do it?


    Kin :) :) :) :)
  • I was in for 3.5 month CT & Checkup. Im about 40% and still a ways from being "Safe" to go back to work. I MAY be released end of this month to go back to work after PT I started to relieve severe tightness of hammies & compromised trunk muscle. Still Im feeling better & getting stronger in back. I have lifted 30 or 40 pounds with brace & feel little pain or pulling in back. Depends on person. I wear stimulator 4 hrs a day still & walk up to 3 miles a day. Hang in there & do exactly as NS says.
  • I wonder how many of you fusion patients use/used a bone growth stimulator. From what I have read it sounds like they arent't necessarely given to all fusion patients. Some docs only give them to people who aren't showing signs of fusion or who have non-fusion risk factors such as smoking. My surgeon gives all his fusion patients one. I am planning on taking calcium and vitamin D for my recovery. It seems it should help since we are trying to grow a new bone basically. Take care
  • Cali-Sue,

    When I had my L3-S1 fusion on 5/1/08, the OS implanted a BGS under my skin and connected the electrodes to the fusion sites. He said the lithium battery will be dead in 6 months, and then he can remove the battery pack from under my skin as an outpatient procedure, providing I want it out.

    I was wondering myself, why they don't implant BGS more frequently with fusions, unless it is a matter of cost and some insurers or WC don't want to pay for it.

    Personally, I am glad to have it, as I am still waiting to be fused (OS said maybe at 3 mos or later) and I take all help I can get. As far as why I got it, I think by OS uses it routinely, as I have never smoked and was in good physical shape before surgery so he considered me an excellent candidate for fusion.

    Kin :) ;) :) ;)
  • My Doc never told me whether or not I was fused. 4 weeks post op for Lumbar fusion he said all looks good, that was five years ago. 4 weeks after cervical fusion in April 2008 he said all looks good. He did not tell me either time to shcedule another appointment. I guess if you are pain free you assume you are fused?

    I feel really dumb right now.
  • Optimist:

    I had a TLIF,L2/3 in Sept. 2007. I was fully fused in 6 weeks, I saw the xrays at that time.

  • My dr never bothered to take any x-rays for me at 3,6 or 9 month and he wasn't worried. I had my x-rays at 6 month and he said that I'm fusing very good. Again he has always told me before surgery that fusion takes from 6-12 month.. Accordingly I wasn't worried about it earlier but was always curious as to how am I fusing?

    Everyone fuses at a different rate, so really listen to your surgeon and wait for when he feels it's the right time to take the x-ray.

    Happy fusing to all...

    Lotus ;)
  • Optimist, yes non-union is also sometimes called non-fusion.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
  • I had 360 spinal fusion revision l5s1 Nov 2 2007 and am still not showing any signs of fusion. This was the 3rd fusion though, 1st fusion didn't take and I ruined 2nd one so I am praying that this one is successful. My doc says I am not a candidate for further surgery because there is too much damage. I have a stimulator that I still use 1 hour per day.
  • Ellen,

    I saw my xrays at 6 weeks also and thought I was fused. Saw them also at 3 and 6 months. My Doctor said to be patient cause it is not possible to have a solid fusion at 6 weeks. Was your Doctor willing to remove your hardware at that time? The hardware is no longer needed once you are fused. I'm coming up on the 11 month mark and I am completely fused at 1 level and half a solid fusion at the other level. This was verified by a CT Scan and when he removed my hardware almost 3 weeks ago. I am now convinced the only way for a Doctor to be completely honest about your fusion progress is to see if they are willing to remove the hardware. You don't have to undergo the procedure but your surgeons response will speak volumes.

  • Kin,

    Being that I have undergone hardware removal, its not that scary of a proposition. Besides, if you have no other problems, the answer is all you are really seeking. You don't have to have the hardware removed if its not causing any problems. Unfortunately for me, I had some issues with it hence the reason why mine was taken out.

  • The BGS I will get is external, nothing to remove. I haven't seen it yet, so not sure what it will look like. Anything to help seems like a good idea. I read they are very expensive, so hopefully insurance won't be a problem. I am not a W/C case, probably should be, but without any definite event that caused my problem it would be hard to prove. 20 years of nursing probably didn't help my back even if it didn't cause the problem. Interesting to hear about your BGS. Take care, Sue
  • Walk, walk, walk.... The more you walk the more it stimulates the area to grow (bone & tissues). I had a three level fusion and wasn't showing fusion till 14 weeks. Then at my 18 week photo, I'm about 85% fused. I've been walking 1-1/2 miles per day for 13 weeks now, and am at 21 weeks post-op. But walking is wonderful in the fusion process.

    Oh ya, and I hope you're not a smoker. Because you won't fuse. Smoking is not an option with our back surgeries.
  • I had L4-S1 fused 5 months ago and just had a CT scan to see if I am fused. That is the only way my surgeon says you can tell. I am waiting on results. I feel like I am fused, because I can do the BLT - bend, lift, and twist, although I don't lift anything too heavy. I'm still having moderate pain, especially when sitting. I walk everyday at least one mile, sometimes two. My stamina isn't great, but that will come. Anyone have trouble sitting? It's soft chairs that are the worst.

  • When my surgeon said I was fused. He could tell it from the X-ray, even I could see it.
  • Does anyone have pain while sitting after spinal fusion? I had L4-S1 fused Nov. 3 and still have pain while sitting. It's hard to travel and drive for more than about 30 min.
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