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cage sticking out a bit ok?

I just had APLF, L5-S1 fusion. A cage was put in between the discs from the front and metal rods screwed in from the back. Based on an initial lack of major complications and only minor nerve/sciatica type pain down the legs 6 days post-surgery, I'm tentatively going with "success" on the surgery itself. However...

While waiting for the surgery, the disc space had collapsed farther than the surgeon had initially expected and as a result he broke one cage trying to get it to fit in. He got a second cage to mostly fit and he said it "locked" in correctly, but it protrudes very slightly out the front of the disc space. He seems unconcerned and says it is so tight in there he can't imagine it moving, and he says that the ones that do shift tend to shift backwards anyhow which would move it back towards where it ought to have been in the first place. It isn't near any nerve roots or bundles and he says it'll still get covered/surrounded by the bone as it fuses over time. He said high bone density contributed to his difficulty getting the cage fully in place and said that's a good sign for long-term strength as well.

So... Anyone with any experience on non-centered intervertebral cages/spacers? The presence of the rods in addition to the cage is comforting knowing the cage isn't perfectly placed, but I'm trying to find out if anyone has any experience on outcome quality for a non-optimal placement of this cage.

Thanks in advance!


  • I am in the same boat. About 1 year after fusion, still in quite a bit of pain on the same nerve path (L5/S1), an mri showed a "disc" protrusion at the fusion level! Looking at it, it appears that the cage has moved forward and is slightly impinging on that nerve.
    When the pain gets too bad, I do my physical therapy (lay on stomach and press upper body up, hold, repeat several times), and it is ok for a while. There is nothing they can do besides another surgery, and I won't go through that again.
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