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Fusion with hardware.

I had a lumbar fusion of the L-4 L-5 S-1 two years ago. My stenosis/arthritis has progressed significantly past the where the fusion took place and as a result is greatly affecting my daily activities. My doctor wants to remove the hardware, as the fusion was a success at that joint, clean out the arthritis, and fuse the next level with some kind of bone compound without using hardware as he says it would limit my movement greatly. Has anyone had fusion with instrumentation ? If so what were the results? My doc says recovery will be a bit linger without the hardware.


  • hvillshhvills Suzhou, ChinaPosts: 732
    I've had the same 2 level fusion as you (PLIF L4-L5-S1) with hardware. I subsequently herniated my L3-L4 disc and the surgeon did NOT make another fusion but rather only "cleaned-up" the L3-L4 disc area... decompression, discectomy, etc... The thinking was that further fusion whould make me very stiff... and would also put too much pressure on the L2-L3 disc. I can't say what he did was right or wrong as I'm only at 9 months in my recovery... but for sure I'm out of pain.
    Harry - 63 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • I;m not sure I understand, but what your physician want to from what you describe is a spinal procedure without instrumentation. Here is the def of spinal instrumentation. "Spinal instrumentation is a method of keeping the spine rigid after spinal fusion surgery by surgically attaching hooks, rods, and wire to the spine in a way that redistributes the stresses on the bones and keeps them in proper alignment while the bones of the spine fuse." SO your last surgery was fusion with instrumentation.
    It seems a bit odd to want to "fuse" without hardware. If your bone fuses at that level it will be as stiff as it would with hardware in it, as it will create a fusion, or bone making essentially one vertebral bone instead of two. Did he mean some sort of vertebralplasty?

    I work at a hospital doing assessments (of sorts) for Neuro and Ortho surgeries. I've never actually seen any physician do a fusion without some sort of hardware.
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