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NEED HELP! Post fusion - pseudoarthrosis???

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:22 AM in Back Surgery and Neck Surgery
Does anybody know what pseudoarthrosis is and how it is resolved? Here is my C-T scan results:

"partial sacralization right side of L5 vertebra with the first sacral segment resulting in a pseudoarthrosis with marginal osseous hypertrophy..."

What does this mean? My surgeon wants to take the hardware out (already know that is causing a problem - screws are threw the muscle and tissue...) and then evaluate at time of surgery when I am under if they should fuse L5-S1 b/c of this. He is thinking yes, but said they will only know if it is a problem when they get in there...

This will be my third major surgery in less than two years, and I have had it.

Does anybody know what this means - do I need surgery to repair pseudoarthrosis?


  • means lack of solid fusion. I am no doctor so I do not know what this will mean for you as far as surgery goes. Please do talk to your doctor about your concerns and please do keep us posted as to how you are doing and what will be done. We are here for you and if there is anything at all that I can help you with then please let me know. Take care , Miki
  • Is basically failure to fuse completely, creating a "false joint". I'm not sure how they would be able to take the hardware out, because that is probably what is keeping your spine stabilized. Once the doctor can see how solid your bone growth is, he will know more. Sorry you are having to go through this. Many people have failure to fuse and don't know it because they don't have problems requiring further imaging. But in your case where you are having problems, my guess is that they will want to re-do your fusion and put in new hardware. But, that is only my uneducated guess. Good luck and please let us know what is going on.
    Surviving chronic pain one day at a time, praying for a reprieve because living another 40 years like this doesn't sound too fun!
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  • I have the EXACT MRI/CT readings pre and post-fusion and was told its its nothing to be worried about it means "false joint" or transitional segment that you were born with- sometimes referred to as "L5-L6" -- check your pre-fusion CT and see if it doesn't have the same comment.
    Loose hardware is another story - then that is the "pseudoarthroses" that means non-union or failure of your fusion to fuse - ask your surgeon!
  • SpineAZSpineAZ WiscPosts: 1,084
    If you are not fusing, which is what pseudoarthrosis implies, then you may need something more to help you. If your surgery was recent sometimes things like a bone growth stimulator can be used.

    I had my first fusion L5-S1 (no hardware) in 1987 and in 1993 symptoms came back. Turns out I had a psuedoarthrosis. I was only 20 when they did the fusion in 1987 so the theory is I may have grown a tiny bit and the fusion didn't occur. So I ended up with an L4-S1 fusion in 1993. The only reason it was L4-S1 instead of L5-S1 was that my L5 would not take the hardware. Fast forward to this year and I had it revised to L3-S1 and my surgeon said "I can get hardware in L5" and he admitted defeat in that after. MY case if very different because I have very loose ligament and tendons so my prior surgeries were for spondylolisthesis and L3 just started creeping forward as happens in spondylolisthesis. Reason is my body just doesn't hold joints together well so they wear quickly.

    If you are having symptoms leading you back to the doctor for the testing and diagnosis then they may surmise that your symptoms are due to the false fusion (pseudarthrosis). That was the theory in 1993 when symptoms returned and indeed the L4-S1 fusion with hardware worked very well and the symptoms disappeared.

    Unfortunately imaging (x-ray, MRI, CT) don't really give all the information we sometimes hope. For example, I went to my spine surgeon after my neck fusion and said I had pain. He said I had very mild stenosis at one level but he'd go in and fix it if I was in that much pain (saying it as if it was exaggerated pain). He told my husband after surgery that he was amazed I wasn't crying (note to him....I WAS crying in his office) because the stenosis was one of the most severe he'd seen. So the surgeon saying that he will make a decision once he opens you up is usually a realistic statement. As a result of this I always tell my surgeons "I give you permission to fix anything you find in there" so even if that meant fusing a level I didn't know about I wanted them to do it because what they find when they open you up is the clearest picture of the problem they get.
    2 ACDFs, 2 PCDF, 3 LIFs; Rt TKR; Rt thumb fusion ; Lt thumb arthroplasty; Ehlers Danlos 
  • I am having a difficult time just trying to find the definition "PATIENT IS STATUS POST FUSION"
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