I was born with a bi-lateral pars defect which caused back pain most of my life. Five years ago, just after retiring, the pain became chronic and I was diagnosed with L5 - S1 level 2 spondylolisthesis. After four years of swimming, physical therapy and steroid injections which had been initially helpful nothing was working anymore, and I was becoming quite depressed. I finally decided lumbar fusion at the L5 -S1 level was the only remaining solution and worth the risk. I selected the head of orthopedic surgery at one of the top hospitals in the nation for a ALIF with rear pedestal screws in October 2013. After a lengthy recovery including permanent nerve damage in my feet and legs, I was once again able to sit in a chair without pain and even doing a little golfing and fishing. Life was good again. But the back pain started to gradually come back and in January of this year it became severe…now worse than before surgery. My recent MRI and CT Scan shows solid fusion, all hardware in place and no pinched nerves. The pain management doctor gave me steroid injections at the S1 level in both the facet joints and lower back muscles which have reduced the pain for the last two weeks if I am inactive, but the least amount of activity brings it right back. Could the spinal fusion caused my problems at the level below in only 15 months, and if so, any recommendations on where I go from here?