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L4/L5 anterior/posterior fusion 2 1/2 years later

AnonymousUserAAnonymousUser Posts: 49,578
edited 06/11/2012 - 7:24 AM in Back Surgery and Neck Surgery
Hi -

I'm brand new to this forum and am looking for similar experiences to mine, or advice/guidance - anything really.
Please bear with me, I try to include important details here.

I am a 52 year-old male, in fine health - except my spine!
In 2006 I had a anterior/posterior (360) fusion at L4/L5, using BMP with cage, screws, rods, etc. Recovery took a while (as expected), but after several months the pain and burning in both legs and feet started to dissipate and I felt pretty good, resuming to normal activity.

After one year I was out helping coach my son's little league team and suddenly started to feel pain returning to my legs. It came on strong and eventually went to see my doc, who ordered images etc. MRI did not show much but CT scan showed solid fusion at L4/L5 (good news), but some residual compression of L4/L5 bilaterally.

I tried injections, anti-inflammatory meds, PT, etc. but no relief. Eventually my doctor suggested I have a bi-laterial decompression to open the nerves up since that was what the scan indicated and I had not responded to anything else, but it was never exactly clear why this had happened - perhaps "settling" during the fusion or some bone growth on the spine's part trying to create extra stability. The ortho surgeon told me it was not likely that the BMP had anything to do with it since it was in the contained intervertebral cage and a year had passed. The screws were not out of place/moved or anything, so he said removing the hardware was not necessary and would require a more invasive surgery which was not what I wanted to deal with.

So I had the decompression in 7/2007, which was a far easier surgery to recover from. I gradually got better, was able to resume normal activity, again felt good, so seemed to me decompressing the nerves was the problem.

3 weeks ago - guess what? Out of nowhere the pain in my legs (knees to feet) started to come back again. The exact same pain and location as before! This is very depressing and frustrating :''( , as it seems I can be "fixed" - but only temporarily.

I am scheduled to see him again this week to tell him what's going on. My questions are these:

- Is it possible the BMP is still active 2 1/2 years after the original fusion? I know at the time he said the only approved application was as a 360, single level fusion, at the L4-S1levels, using the cage and hardware (infuse?), so as far as I know he didn't do anything that wasn't FDA-compliant or on the up-and-up. (Fairly reputable Bay Area uni hospital.) I read a lot on the internet about BMP a the time and it seemed like a reasonable approach in my case.

- Is it possible that me being fairly active after I felt better is causing bone to regrow? Since a solid fusion was found at L4/L5 and the fusion is solid it doesn't seem to me like anything can be "moving around".

- Anyone have any kind of experience like this? I'm at my wit's end as the discomfort (that I am SO familiar with) is putting my life on hold again. Some of the talk about BMP bone regrowth in this forum scares me and I'd like to know more, like how long can the BMP still be active?

Any and all advice is greatly appreciated!



  • Hello and welcome to SH. You have found a great site of information and support. I am 11 weeks post fusion, so too early yet but I wanted to bump your post back up top for ya.
    I too had BMP and would be interested to know its length of action. Take care, Sue
  • that question today and he said that when they place the BMP they place it in the vertebral body on the outer side of the canal so there is no way it can cause excessive bone growth. He also said that it can only keep growing when there is something to grow (attach) to. So as a rule they place it so the fusion encapsulates it and thus no overgrowth.
    This means that it stops being active when fusion has surrounded it.(That was my take on it)

    Bleep I am sorry you are still having problems.
    What sort of lifestyle do you lead? You said you are active but does that include your job or are you sitting a lot.
    I think you need to ask the surgeon some pretty hard questions about wy the hardware sin't keeping the vertebrae from compressing.
    Please let us know
    Blessings Sara O:)
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  • Hey there,

    I'm similar with you in the case of feeling good after fusion, but then going downhill. Trying to teach kids the proper way to field a ground ball is tough after a two level fusion!

    BMP may or may not be the issue. There was a version of BMP (BMP-2) that studies have shown some instances of hypergrowth. But, your doctors should have been able to see that in the last round of xrays.

    As much as I hate to say it, I think we are both in the same boat that we either learn to work around what triggers the pain and neuropathy or keep doctors busy looking.

    I'm going hiking in the mountains today and horseback riding, so by tonight, I WILL be hitting the medication!

    Best of luck!

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • I wanted to thank everyone for their thoughtful replies. This forum seems like a great source of information and and support. I feel a little more hopeful already. ;)

    (I hope I'm posting this in the right place, kinda new to this.)

    Angelback - My lifestyle is pretty active in that I walk my dog every night for 30-60 minutes (more like 20-30 now that my feet burn while walking. :( ) And more on weekends. I go to the gym and do light weights once a week too. Or did anyway.
    I have a standing set-up at work so I stand a little, sit a little at work.

    I'm pretty sure walking is not a problem but now I am wondering if going to the gym and being generally active was a good idea. I felt good, so it seemed ok to do "normal" things like lifting stuff and gardening, etc. My surgeon said I could pretty much do anything within reason since the fusion was solid. Now I wonder.

    These are the sorts of things I sort through in my head as I lie awake at 3AM wondering why this happened. I'm sure folks here can relate to that.
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