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leocat46's picture
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CT results! failed fusion

so i had my appt. for follow up from ordering a ct scan of my cervical 2 wks. ago from N.S. , who did my surgery last June 09. been 10 mth. he walked into the room, and asked how i was feeling, i told him the same, extreme pain in the neck, sharp piercing sometimes, upper back burns, pain down arms, and left thumb and index finger. and also pain in radiating into my ears, and somedays i cannot even turn my neck at all. He then asked me if i could live with the pain?? I looked at him, and he proceeds to tell me that there is a gap in the cadavor bone he used, but the hardware is fine. but he tells me that since i have rsd, and fibro, and all my other issues, it is hard to tell where the pain is coming from. He said he could go back in and redo the surgery, only this time he would have to use bone graft from me. and with rsd, it would hurt worse , and he could not guarentee that the surgery would even help. so my husband was with me, and we already have an appt. with another big university somewhere else, with a specialist at the end of the month. so we are going to wait and see what he says , and go from there, their are alot of issues to address with me, and now i have just added another one. Worried i really have enough chronic pain going on the way it is, the ct scan also showed a weakened disc c2/ c3 also above. Jeesh! At Wits End can anyone tell me were they told the same thing as I was about results? mine was c5 / c6 by the way. with plate and 3 screws. Confused thanks for listening soft hugs LEO Big Hug

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CRPS -(aka)chronic reflex pain syndrome, Fibro, OA,spinal stenosis, SURG: lumbar surgery 1988,3-c-sections, left shoulder rotary cuff tear 8-2008, turned into frozen shoulder, and rsd, shoulder manipulation in feb. 2009, not much improvement. ACDF- 6-2009. wish i could say i was doing better. taken alot of meds, perco, vicodin, darvocet, neurotin, cymbalta, prozac, flexeral, tizanidine, pregnizone packs, steroid shots, pamelor. effexor XL ,topamax, tofranil

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I have the same problem

I had a 3 level fusion 2 years ago. Mine was c4-7. the c7 bone (cadavor bone) did not fuse. He didnt do or say anything. They said to just wait and see. Well my primary dr. is sending me to a nero surgeon at the end of this month. He said this is a very good Dr. and he trusts him. So Im hopeful to see what he will do. I will let you know what happens. I hope you can get something done to help you. Good Luck

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Life is what you make of it. Think possitive and be well.

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I too had a failed fusion

I am sorry to hear this has happen to you, I had my first surgery Dec. 8, 2008 C4-7 with cage, plate & 8 screws, three months later I had new pain on the opposite side of my neck. Sept. 09 they found my plate was loose and I did not fuse, so they sent me out of town from my 2nd surgery Dec. 2, 2009, he went through the back of my neck with rods and bone graft from my hip. This new doctor was a straight shooter, he made it clear to me this surgery was to stable my neck, not to take away my pain. he gave a 50% chance my pain would improve a little. Will it's been 3 months and the pain is worse and I have applied for SSDI, they have me on Opana Oxymorphone, Percocet and Robaxin, these help but don't take the pain away.
This 2nd surgeon did ask me why the 1st surgeon didn't use my hip bone graft, he said using my bone is a big help getting it to fuse. I have learned a lot the past two years, that doctors really can't tell my how I feel, when I say my neck hurts and it is not muscles I know what I am talking about and I don't let them tell me how my body feels anymore.
I hope you find some answers you are looking for, my wife has fibro and other problems that caused her to gone on SSDI in 2002. We are lucky to walk this life together, on the 24th we will be married 31 years, little could we have predicted that we would be helping each other like this.

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Rickety

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Three screws?

Hey, Leo - you said with your 1-lvl ACDF you had a plate with three screws? Why only three? Shouldn't you have four screws in there?

Just curious...

I'm sorry about the failed fusion. I'm not fused at my C6/7 level as it's the most difficult to fuse because that area moves every time you move your head. Luckily, I'm not having any major symptoms because of this, so I'm not going to deal with it until something changes.

Take care and I hope you get the help you need.
Cath

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~ October 21, 2008 - ACDF, 3-level (C4/5, 5/6 6/7), with hardware and eight screws. All fused and hardware is stable.
~ January 6, 2010 - TLIF at L4/5, two rods and four pedicle screws.
~ July 2010 - New CT and MRI on cervical shows further problems above fusion at C2/3 and worst at C3/4.
I am in no way affiliated with the medical profession. Any recommendations I make are based on my personal experiences only, so do not take my comments as medical rules.

leocat46's picture
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thanks for the replies

first of all RICK-- i know what ya mean, you keep telling these doctors over and over how you feel, and like they don;t listen or something. i know what i am feeling, believe me , or us we don't want to make this crap up if we didn't have to! it makes me so mad to know that we are overlooked sometimes, and it should have been addressed before hand. we all do not want to go thru this pain, and meds all of our lives. i just want to let you know i understand. Smiling i also am in the middle of appeal for SSD with representation also. hopefully it comes thru this time, i can no longer go on with all the pain and restrictions anymore, not to mention depression. so sorry to hear about your 2nd surgery rick, i hope it does not come to that for me.
hey CATH111-- i did not know about the use of more screws, it would not surprise me that he should have used more.
SOUTHFORK GIRL---please let me know what you find out at your appt. with your dr. at end of the month. my appt. is the 25th of march. i will update mine as well. are you having same symptoms as i am ? my meds don't control it all the way.somedays it feels like my neck is so tight , and can't move it at all, and some days it feels like a one of those bobble heads that has no support, like it is going to break off, with pain of coarse. i don't know what to think. Confused well good luck to all of you i will keep you updated LEO

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CRPS -(aka)chronic reflex pain syndrome, Fibro, OA,spinal stenosis, SURG: lumbar surgery 1988,3-c-sections, left shoulder rotary cuff tear 8-2008, turned into frozen shoulder, and rsd, shoulder manipulation in feb. 2009, not much improvement. ACDF- 6-2009. wish i could say i was doing better. taken alot of meds, perco, vicodin, darvocet, neurotin, cymbalta, prozac, flexeral, tizanidine, pregnizone packs, steroid shots, pamelor. effexor XL ,topamax, tofranil

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Revision surgery

I will say the gold standard for revision surgery is posterior surgery using your bone from the hip. However leo, in your case since you have RSD of the shoulder I don't know if it is a good option for you. To much pressure put on the shoulders during that surgery. But at this point and time a surgeon whom is going to take the risk would be nuts not making sure you are smoke free. I know we discussed the issues of the possibility of non-union back in August of 09 from smoking. So I am actually not surprised that you didn't fuse. Hopefully the new surgeon will have some answers of what can be done. BMP can be used in place of your bone on the posterior side although the FDA has warned against using it in the cervical spine for the complications that it can cause. Some surgeons can justify using it, though depending on the issues. I will be using it in a up coming surgery, posterior, only because I have a documented case of psuedoarthrosis. I had it placed anterior on one surgery and I don't recommend using it that way and I think a surgeon whom over looks that warning isn't doing the patient any favors at all.

I think in your case besides the CT scan they should be running a EMG to see if any of that is active denervation. They could place you in a bone growth stimulator and see if the level fuses, but then again you would need to quit smoking to have a chance with it. The stimulator is not cheap by any means at all, so hopefully your carrier would cover it. Good luck with the new surgeon hope he has some ideas, for you.

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get off the smoking EDIT!!

get off the smoking Edited!! Geez I get tired of hearing it.

Post edited by Authority member haglandc for Inappropriate Language

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07/21/09
Microdiscectomy L5
08/08/09
Left shoulder decompression
12/23/09
ACDF C5/6 - C6/7

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justme53

Smoking and failed fusion is very relevant to the discussion. I'm sorry that you get tired of hearing about it, but it's a very real and very serious issue. When there's a case of failed fusion and people start to ask "why" or "why me", it is very common and relevant to see questions in regards to diet, exercise, health, medications and smoking.

"C"

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“If it is not right do not do it; if it is not true do not say it.”

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and its never really been

and its never really been proved that it effects fusion and bone healing. non-smokers and doctors just love to through in your face. You show me some scientific results that proves it!! we all know smoking is a no-no and I'll admit it's probaly killing many of us. when is "crap" such a bad word that it has to edited out of a post? I mean come on.
This is the second time I've been scolded by you for about this same discusion, are you a bit bias?

_____________

07/21/09
Microdiscectomy L5
08/08/09
Left shoulder decompression
12/23/09
ACDF C5/6 - C6/7

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I can say that

by your tone and method of posting, you are attempting to create a scene.
I would strongly suggest that you read the forum rules and understand why they are in place and what the overall objective of this site is.

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Ron DiLauro
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Discussion

When opposite sides of a topic are discussed, invariably someone is going to get upset. Most just walk away at that point. We are responsible as individuals for the health and well being of those around us who we choose to assist or in this case choose to reply to in a forum. Grasping at straws or sugar-coating information isn't going to help many, in fact it usually tends to do the opposite.

If a person wants to get their message across, a civil discussion is generally the best way. As soon as inappropriate language is used, the discussion gets derailed and many times never gets back on track. The context as well as word/s used, and the target they are being aimed at, all combine into making something normally benign into some inappropriate.

"C"

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“If it is not right do not do it; if it is not true do not say it.”

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Failed ACDF?

How do you know if your ACDF has failed? Does an MRI show fusion?

tpm
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Non smoker

I have had an ACDF of my C5-7 back in March of 2007 and it fused within months. I had another ACDF of my C4-5 in March of 2009 which never fused and it's been a year. Also have a herniation of my C3-4. I have never smoked but yet my fusion never took.
I'm not sure just how much smoking plays in having successful fusions

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Tom

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Non -fusion

hi tom , i am so sorry for your non-fusions as well. yu have had two out of three i see. you must be going thru alot of pain, and to say the least alot of anguish right now. i am glad you were able to share your results with us. i would like to know if anyone has any comment on him, for i know there are others out there just like him. thanks again Leo

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CRPS -(aka)chronic reflex pain syndrome, Fibro, OA,spinal stenosis, SURG: lumbar surgery 1988,3-c-sections, left shoulder rotary cuff tear 8-2008, turned into frozen shoulder, and rsd, shoulder manipulation in feb. 2009, not much improvement. ACDF- 6-2009. wish i could say i was doing better. taken alot of meds, perco, vicodin, darvocet, neurotin, cymbalta, prozac, flexeral, tizanidine, pregnizone packs, steroid shots, pamelor. effexor XL ,topamax, tofranil

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Failure to fuse

Tom,

Sorry to hear that you have a failure to fuse. The question is has it failed to fuse or do you have psuedoarthrosis? There are two very different situations. Psuedo means false joint. Some Doctors will group them together but they are not the same thing they have the same outcome, though. In your case I am looking at your avatar and it appears that your surgeon used two different types of plates? There are two types of plates. rigid plate design and the dynamic plate design. Do you know why your surgeon didn't remove your original hardware, after it fuses the hardware really serves no purpose. I like you had a level added into my fusion, and the same type of hardware was used and was just attached to the other plate keeping me with just two screws(left and right screws0 into the same vertebre. Although on your avatar it only shows the one due to being a side view. Research does suggest that dynamic design is the better result for fusion. Grafts can settle, dislocate and a hoist of other issues can happen. I can't tell by the films what type of hardware it is but the second plate that was used is not something I have seen before, so don't know much about it. I would also suggest if you have a herniation at c3-c4 you are blowing levels to fast at this point and time. Do you have arthritis or DDD? I blew levels way to fast and now I need a surgery to stabilize it all up doing a 360 surgery. Do you have any stability issues at this point either retrolisthesis or spondlyolisthesis? In my cases the levels blew faster from a stability stand point causing it. I also lost a muscle group from one of the surgeries causing some of the instability. In your case I wouldn't definitely speak with your surgeon as to why you had a failure to fuse, he/she will have a idea as to why it happened.

AS far as smoking and fusion. Bone is a living tissue and it depends on functions and supports by other body systems. You are trying to grow bone into the cadaver bone or whatever type graft was used. In the circulatory and blood vessels smoking hinders circulation due to plague deposits and narrowing of blood vessels. Smoking reduces the amount of oxygen in the blood and increases the level of harmful substances, such as carbon monoxide. Because bone is a living tissue another reason we support health eating, as well. I surely could never tell anyone what has caused their fusion to fail but I would do everything in my power to secure a successful fusion not hinder it, but that is just me then.

tpm
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Pain is a constant

Thanks for replying leocat and tamtam
I have been on pain killers since 2005 and to date I cannot get through a day without them. I get very bad pain behind my head, neck, and into shoulders and upper back. I constantly feel downward pressure as if someone is sitting on my shoulders.
As far as my hardware just looking at my x-rays I can see I have 4 screws in my newest surgery. Before surgery my surgeon explained that my old hardware had pre-drilled holes allowing a continuation of new hardware. I see that didn't happen. He also said it would be too invasive to remove the old hardware but would have during surgery if it called for it.
I did have some retrolisthesis but that was corrected during surgery.
I am pretty much no where better off than before surgery but it can always be worse right??

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Tom

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