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11 Months since failed L5-S1 fusion. How long until hardware "gives out"?

2

Comments

  • How long ago was your surgery and were you required to wear a bone growth stimulator?

    I have had to have revision surgery but not to put in my own bone to try to get the fusion going. What type of bone growth material was used for your fusion surgery? I couldn't determine by the way it was written. Most likely just me.....
  • November 3, 2011 is the surgery date, and my doc used another bone source rather than my own. I wore a bone growth stimulator for 4 mos. I guess it didn't really help. I have severe osteoporosis and I'm wondering if that prevented bone growth.

    For your revision, what levels were affected, what did they do, and how long was your recovery?
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  • For the revision on level L3-L4 I had a 360 done. I also hade broken hardware whichwas removed and replaced. This was a pretty big operation for me and it took a long time to really get going again. I was on a bone growth stimulator for 9 months 24/7 and I did fuse this time. Good thing. Now having issues with 2 lower levels I guess from the addded stress put on them. Going to have them done on the 12th.
  • I've read that adjacent levels are stressed. Seems like once a person has back surgery, they are never the same. My dr. said I'll never be "normal", that he aims for 70-80% improvement by the 6 mo. mark. I'm certainly not there yet.

    I wish you the best on your upcoming fusion. It's tough being out of work, and in such pain isn't it? ugh take care.
  • Same here...

    I had a TLIF @L5S1 last June and also did not fuse. I knew something was wrong 6 months ago, but I was just ignored. I must have been stuck on the meds , lots of fighting for adequate care.

    Finally a CT scan was done and my 'new' neuro showed me clearly on it that I was NOT fused.

    Anyhow, original surgeon is looking to have been less through all the time as new neuro had a discogram performed. I now have been diag'd with a bad L3L4 and L4L5 as well.

    (I enjoyed showing those results to old neuro place that day, pain seeker my @ss, they missed two ruptured discs)

    A discogram was no fun, but knowing what I know now, I would have NEVER agreed to spinal surgery without one.

    Anyhow, I am looking at a two stage revision that will be an 2 level XLIF for L3->L5 and another posterior surgery to fix L5S1 by adding new graft (own) as well as instrumentation for all levels then as well.

    To each there own, but knowing what I know now nobody IMHO should consider surgery without a discogram and should not sign off on a supposed successful fusion after until a CT has been done...and read by more than one person.

    Just my .02... well maybe .03 ;-)
    Jun 2011 -TLIF @L5-S1
    Mar 2012 -NonUnion @L5S1
    May 2012 -Multi Level Discography
    July 2012 -XLIF 2Cages @L3L4/L4L5
    Aug 2012 -All New Hardware @L34L45/L4L5/L5S1
    Mar 2013 -FBSS = Pain Management until they figure it out.
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  • How did you know that something was wrong, 6 mos post surgery - what symptoms did you have? I think I've heard about discogram and that it's quite uncomfortable. One neuro I saw wanted to perform one before proceeding, but I went elsewhere for a 2nd opinion. The ortho surgeon said we can do one, but it would not change his surgical plans for me.

    I hope your next surgery for the 2-stage revision goes well, and is successful. I have severe osteoporosis which is probably why my fusion failed. Not sure what they would do about that! It gets old being in pain all the time, every day doesn't it? Take care.
  • My diagnosis had always been low back pain that was mostly lower lumbar.

    My diagnosis was also radicular neuropathy in my rt leg. Mostly in my quad, but it does effect the whole leg when it's bad, but quad and inside knee are the hot spots.

    All my MRIs showed a herniated / budged L5S1. It also showed it was in the epidural space.

    L4L5 was only half dark and the rest were white, we asked about but were told "not to worry"

    3 months after my TLIF @L5S1 I went back to work and started PT. I had been coming down from post op meds at a fairly good clip, but suddenly hit a huge wall. At first we figured it was just the new pain from PT etc. After a month though the locking up started again and then the leg. First sore, then constant burning. All classic signs of instability. Like many on here who have been in the spine game for years and years, we know our bodies, I knew all was not well. The next 3-4 months was all out war trying to get taken seriously (read pain mgmt usual BS) and to get a CT. Even after the CT they swore I was fused.

    After just about giving up hope I started making inquires on my own time about other neuro's. As mine had left the practice while in pain mgmgt (same place) and their ortho and him both said fused. I got some good feedback on my current neuro. 1st visit he read my op notes (I always get copies of everthing) and he then read my MRIs and CT. Took him all of 5 min to show me on a 27" screen how I was not fused and that my op notes showed techniques he feels show a lessor skillet. Regardless he said he would fix it but not without a discogram as my leg pain would not be L5S1.

    Fast fwd my disco showed 2 more bad discs and the one causing my pain was white on the MRI. It shot off the table during the discogram, hurt like hell, one above it, nothing.

    So in the end 11+ months later I am unfused and have 2 other bad discs I have probably always had.


    So three things, I still had leg pain, instability and I started locking up again.

    I spent many years avoiding surgery with Chiro, Rolfing, PT, yoga balls, etc. etc... I got really good at knowing my body and what did what, how to undo it, etc.

    It's hard to do when we are so closely involved and medicated and frustrated, but without sounding all horse whisperish... Pain is a neurological reaction that protects the body and tells the owner something is wrong. When we listen carefully it will help guide us in the right direction.

    That and I am an info junky. When I have to be involved with something I deep dive into it and educate myself with anything and everything I can get my hands on. I have all my notes, reports, films, etc.

    Education and understanding helps us own our issues and they are ours to own. The more we own it, the better one can self advocate. This knowledge saved me more than once when I had to fight to be heard.

    Anywho, now most likely looking at a 2 stage revision that will also fuse L34 & L45 via XLIF. Probably in June or July.

    My.02.... Well probably .03 :-)

    Cheers
    -wsn

    PS: After all that I woud never advise anybody to go under the spinal knife without a discogram.
    Jun 2011 -TLIF @L5-S1
    Mar 2012 -NonUnion @L5S1
    May 2012 -Multi Level Discography
    July 2012 -XLIF 2Cages @L3L4/L4L5
    Aug 2012 -All New Hardware @L34L45/L4L5/L5S1
    Mar 2013 -FBSS = Pain Management until they figure it out.
  • So, I know this is a slightly old thread but I'm sure some of you would live to know (including the OP) that new options are coming soon!!! TE-IVDs (tissue engineered intervertebral discs). This is a tech I've been keeping an eye on for a few years now and it's finally gaining some momentum (they recently made viable discs for dogs...a step up from the first TE-IVDs made for rats...soon they'll have them for us I hope!!). If all goes well, you can order up a new disc (L4-S1 in my case...) and ideally, after revovery you should be almost good as new since all the mechanics of the original disc SHOULD be maintained. Another tech is from discgenics and they use a combination of tissue engineering and regenerative medicine to repair damaged discs INSIDE your body (using stem cells and other fun stuff...I haven't followed this as much since I'm missing a disc...so there's not much to repair =p) but for those of you with herniations, tears, and possibly even collapsed discs, this may be a new alternative to discuss with your physician/surgeon.

    As for the original poster. If you need a surgeon that is hands down the best around (granted that's opinion, but he's WELL recognized in the field), and if your close/willing to make the trip, if HIGHLY recommend the Spine Center @ Cedar Sinai in Los Angeles, CA. My surgeon was Dr. Anand and as I've said before he's regarded by many as one of the best spine surgeons in the country (the prognosis I received from 3 other surgeons was needing additional surgery every 5-10 years because of my age, 25, and extent of injury...not to mention they all recommended multiple levels be operated on... @ cedars: L5-S1 TLIF w/ BMP, PEEK cage & titanium hardware; L4-L5 microdecompression only... His opinion was the L4/5 was more than strong enough to hold up added stress following fusion assuming I got back into shape...well I did my part of getting back in shape and 1 year post op...my L4/5 still strong and I have a new prognosis...I'm 25 today, I'm not expected to need surgery until my late 30s/early 40s...barring another injury)
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