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How to tell if ACDF is fully fused vs failed??

IthicaIIthica Posts: 18
edited 12/28/2015 - 7:41 AM in Back Surgery and Neck Surgery
Hello - thank you for taking the time to read my post...

I had C5-C7 ACDF in March 2015 for Cervical Stenosis resulting in Myelomalacia and left sided upper and lower extremity radiculopathy. My recovery was slow but progressing as expected for 2 months. Then when screwing a light-bulb in to a ceiling fixture (of all things) I experienced electric shooting pains followed by severe bilateral upper extremity weakness. My surgeon ordered an MRI which showed the surgery site was "healing". The weakness slowly resolved by itself over 48-hour period and my doctor said it was caused by irritation of surgery site; however, he said my MRI showed I would need surgery at C3-C5. Since my surgery in March I have had increasing periods of pain over the spine itself that are usually relieved by a course or two of oral steroids. For the past 2 months oral steroids have not been helping and I ended up in the urgent care for x-rays. Urgent Care doctor said x-ray showed Psuedoarthritis and possible failed fusion but I needed a CAT scan to confirm. He suggested I contact my surgeon to get the order. I have attempted to contact my surgeon by phone and messaging (patient portal) and have gotten no response. Since this time I self-referred to Pain Management and have had 1 ESI so far that has not helped. I asked the Pain Mgmt doctor about the CT scan and he opted to start by ordering x-rays of the c-spine.

My questions - can a failed fusion be determined or ruled out by XRAY or is advanced imaging needed? Is a CT scan or is an MRI preferred for determining a solid vs failed fusion? Since surgery, my strength in the LLE is about 95% recovered and LUE is about 70% recovered, however I am having a lot of pain that is different from before the surgery. It is less in the extremities and is more over the upper back and neck itself. Could this be a result of the C3-C5 issues or more indicative of a failed fusion? Is it possible the surgery site is still healing/fusing or is any fusing done at this point? I'm sure there are some people on the forum with experience in failed cervical fusions - is there any advice or insight you could provide me?

Thank you in advance.
Thank You


  • Motor1MMotor1 Pittsburgh, PaPosts: 552
    edited 12/28/2015 - 9:48 AM
    First off... It says my name is Nick.ny??? That's not me? My name is Motor1?

    I had ACDF C4-5 that failed to fuse. My surgeon refused to see me after my 6 week check up. I would call his office to tell him that my pain was worse after my surgery & his assistant told me that everything was fine & he wouldn't refill my pain meds. He told me his job was to perform the surgery, and he did that. So he was no longer my doctor?
    I researched & found another doctor. He took an X-ray & showed me on the film that my neck never fused. This was 8 months after surgery. He had me wear a bone growth stimulator collar for awhile, but it didn't help me fuse. I ended up having another surgery through the back of neck this time. It was much more painful!
    I would suggest, if you can't get an appointment with your doctor, go get a second opinion.
    Good luck!

    Name differences. That is a situation regarding system and browser caching. You may see your name different but others will see it as you. Clearing your browser cache every so often helps avoid this situation
  • gfishggfish Pittsburgh PAPosts: 158
    After 1 year of T4-T10 fusion. Mine is not fused. Pain level is the same as before, even worse at time. My doctor said the same. Everything he did is all good. There is no reason to see him. Like its my fault. What killed me is he said I couldn't be fixed! Only stabilised. The pain and problems are something I will have to deal with forever. Looking at second options, But not sure it would wise. Could end up worse. Remember its your body and life.
    Greg fisher
  • Well my PM doctor ordered an XRAY. When I went in for my last ESI he said he looked at the XRAYs and he said it showed the vertebra above and below the surgery site had degenerated further and slipped out of place. I asked him if the surgery site looked fused and he said "as far as I can tell". He said the injections may or may not be helpful but we would continue as planned. When I read the radiologist report it said I had Stage 2 Spondylolisthesis at C3-C5 & C7-T1. It did not mention if the surgery site was fused or not. It did say the hardware was in place and has not failed. It did say - C6-7 bone graft appears positioned in the ventral portion of the disc space. I don't know if that is significant or not.
    Thank You
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