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Posterior hardware or wait it out

candle99ccandle99 Posts: 279
edited 06/11/2012 - 7:25 AM in Back Surgery and Neck Surgery
I'm 4mos postop from ALIF L4/L5 and have started having increased pain. I've not really been out of pain, but the past 2 to 3 weeks has been worse, more sharp. Had all the tests again, MRI, Myelo, CT and NS says it's just the fact that I'm not fusing and there's too much movement in the vertebras. One of my cages has moved too and pushed some disc material out into the spinal canal.

I have 2 options....to have a 2nd surgery to add screws/rods in posteriorly to tighten down things or to wear a bone growth stimulator and wait out the fusion process.

I'm trying to set up a 2nd option appt today with a different NS.

But I wondered if anyone has been thru this and what did you do? Seems like everyone has either had a PLIF or ALIF both with extra hardware. I'm with cages only. Do you think my NS is worried that I will say he didn't do enough? He's being very nonchalant like he sees this everyday and of course, I'm frustrated and in pain.

I'm really leaning towards having the 2nd surgery but have read you guys posts about posterior surgery taking 12 weeks or more to recover.

Any opinions?


  • Hi

    Cages with no hardware....I did not know that. Usually they use screws and rods.

    Yep ....recovery can take 12 weeks easily.


  • Candle, so does the surgeon think this disc material is the cause of your pain? My concern would be even if you fuse, will the pain still be there from the disc material pressing on your nerves. I think the second opinion is a great idea. Just to get another take on the whole thing. I hope you can arrange one soon. I know it is hard to get these appointments sometimes taking a month or more. Good-luck, I hope you get some more answers soon. I think your surgeon should commit to what he thinks is the best fix for you as well instead of being wishy-washy.
    >:D< Cali-Sue
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  • Some people do have ALIF's without posterior hardware. In that case, typically plates are secured to the anterior portion of the vertibrae to prevent movement.

    Having hardware placed in a minimally invasive fashion isn't a huge recovery deal. Of course, you will be sore. Ask if he/she will put the hardware in using a minimally invasive way. If he want's to do it as a full blown open incision PLIF, that is going to add time to the healing process.

    I had the 360 ALIF, with bone growth stimulator and a back brace. My NS didn't want to take chances of non-fusion.

    Hope this helps.

    Several Epidurals, L4-S1 360 ALIF, Numerous Facet Joint Injections, RFA x2
  • What's the chances that my NS is using me in some study or something? I can't seem to find much at all on ALIF with cages only. Pretty much everyone is using hardware too. Just any search engine doesn't turn up much at all. There are studies that show fusion without hardware isn't as effective. Why would my NS not have wanted to avoid non-fusion? I didn't know I was such a different case than everybody else. Makes me wonder if he's doing a study where I'm a test case.
  • Candle99,

    If you were in a study you would have had to have signed consent to it so anything outside this is NOT ETHICAL!

    I would still consider this second opinion or at least challenge the NS why he chose NOT to use hardwear when most of the research "currently and gold standard" is to use interbody spacers with hardwear. See what he says.Perhaps print off one of the studies and take it with you. Make sure it is one where there are a good number of patients included (like 300 or so, not a study on 10 people because it doesn't really show much of value)

    Pain Free days. >:D<
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