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What happens next if my revision surgery failed?

I will try to summarize as best as possible. Car accident 3 years ago. Cervical fusion and ALIF l4-s1 done in March of 2015. October 2015 surgeon saw that my bone did not grow and my titanium screw broke. I had to do a revision surgery, posterior. He also inserted a huge rod on my left and did a bone graft on my right, for extra stabilization. I am in the worst pain ever right now. It's been 3 months and I am still on the same amount of meds I was d/c from hospital on (I.e. tons of morphine and dilaudid). I am having extreme pain where it's debilitating - can't even sit up in bed at times, forget walking, and my legs and feet go numb. Steroids help but can't take those forever, plus they're trying to not do anything that's contraindicated with fusing. Surgeon said there was a less than 1% chance of the first fusion failing, and it did. I'm not overweight, don't smoke, did everything right. My neck is fusing just fine. So - I was supposed to be able to go to outpatient PT in January, but my 3 month x-ray showed no bone growth yet, so it's on hold right now. I feel like the pain is getting worse every day. I know in my heart and in my gut that this surgery also failed. I know it's not fusing and probably won't. What happens next? MORE surgery? Wheelchair? What the hell do u do if you never fuse??? Please help, I am going out of my mind :(
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13

Comments

  • Bruce EitmanBruce Eitman Akron, OH, USAPosts: 1,510

    Whose bone did they use for the fusions?

    I ask because almost two years after my first surgery, my surgeon told me that when doing multiples sometimes one will form bone better than the other.  So for my second surgery (new fusion C4-C5 and redo of C6-C7) he used bone from my pelvis.

    My second surgery was also in October, so we must wait to see if this is better.

    Bruce

    Read my story at Bruce - My Story
    ACDF C4-C5-C6-C7, and getting better every day
    It has been a process of healing, learning, exercising, and resting - and figuring out when to do which.

  • hvillshhvills Suzhou, ChinaPosts: 971

    Revision Surgery...

    I also had a revision L5-S1 fusion surgery in January 2105 as the original fusion surgery in May 2013 failed due to a weak and incomplete fusion. The revision fusion took a FULL 12 months to fully take...I think to call your fusion failed at 3 months post-op is too early.   Also due to nerve healing problems I was on pain meds for 4 months after my second fusion surgery and like you thought I would never see the light of day again.   What did your surgeon say about your 3 month x-rays???

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
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  • So they used cadaver bone - from multiple donors, crushed up is how the doc explained it. That truly is a question I have - with the first one failing, I think that maybe it would have been a better idea to use my own bone to stimulate rather than donor, because I'd think my body would 'recognize' it more, ya know?


    And yes - I know 3 months is early - but with the amount of pain and dysfunction I am experiencing, I just think it's pretty safe to assume it's failed. I'm probably biased, but I just feel it. And what am I supposed to do if it doesn't fuse for a year? Did you have to act like you're made of glass until it fuses? Because I don't want to break more hardware! Uggg. And my surgeon just said that it's early and we'll 'just hold off a month' regarding the PT, but I know that means we're taking another x ray in a month and if you don't have bone growth yet then no PT. But - that is hopeful to me, so thank you for that story.


    So let's say I'm right and it is failed.... what do they do? What are the options after 2 failed back surgeries? Do they just leave you be or what?

  • hvillshhvills Suzhou, ChinaPosts: 971
    edited 02/08/2016 - 6:25 PM

    If the fusion fails...

    I would guess they would do a 3rd fusion surgery.  In a new surgery using your own bone is a good step... using BMP is a good step... using "stem cells" (not really stem cells... but like it) is a good step and adding Iliac bolts might also be a good step to help ensure a good fusion. You can research more about these options here on this website and/or discuss with your doctor if the situation comes up.  However my bet is you will fuse now...

    Have you talked to your surgeon about using a bone growth stimulator now?

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • Bruce EitmanBruce Eitman Akron, OH, USAPosts: 1,510
    I just returned from a follow up visit.  Surgeon is recommending a bone growth stimulator for me now.

    Looking at my x-rays it is clear that bones are forming, but the vertebrae have not come together to form one bone yet.  I do have one well formed fusion from Dec 2013 which gives me something to compare against.  I point out that they haven't fully fused because our surgeries were so close in date.

    Nobody ever told me to act like it is glass.  I have done the opposite and gone on with my life, although my life doesn't involve much danger like BASE jumping or acrobatics.

    So tell us about you pain.

    Bruce

    Read my story at Bruce - My Story
    ACDF C4-C5-C6-C7, and getting better every day
    It has been a process of healing, learning, exercising, and resting - and figuring out when to do which.

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  • I had a bone growth stimulator I used for 6 months. He wants me on one ASAP for this.... but apparently my insurance won't cover it now because I already had one. Well, they can bite me and pay for my next surgery I guess.


    My pain - is insane. There is no way I would be able to resume any kind of normal function still :( So that isn't a good sign.


    So they'd do a 3rd fusion? I don't even know how that would be possible, they've entered front and back and I'm scarred up everywhere. I'd think scar tissue would be a problem? Ughhhh I just don't know. Hopefully I'm just getting way too ahead of myself. But sometimes, you just know things. And I feel like I know this. Too much.

  • So, Ive failed. Surgeon isnt calling it thay yet becase hardware is still in place. But i have had literally no bone growth and im 5 months post op.

    My pain is exactly the same...horrendous. Shoot...i was WAY better off my first time around, i was running 5ks then. Right now  at work or in bed on ice and bawling and screaming.

    Im back to work because im about to lose my house to foreclosure and everything else. This has completely ruined my life.

    Id take my own life if not for my kids. I canmot live like this. And i dont know what the next steps are. What do u think? More cutting? Do they wait for me to break this hardware?

    Living hell.
  • So sorry to hear the bad news ! Unfortunately, a lot of us on this site are all facing the same scenario. I have had 2 ACDF's one with hardware and one without. Truth be told the first one was a lengthy recovery but the best outcome. Like you the second one NEVER took me out of pain and of course the surgeon doesn't want to own that right away. I had my second ACDF 3/5/15 and been in pain for almost 2 years now ! I have had 3 opinions all suggest more surgery and most suggest "failed fusion". It has been a living hell and the ONLY alternative is more surgery.

    Things they never tell you are - with secondary surgeries there is a 30% chance of failure. They also don't mention that adjacent disc disease can also occur rather sooner than later. At least in my case it has !  I played the head games and denial, thinking I could live with this pain ! Nonsense ..this is no life - living with pain and narcotics to get you through the day !

    So what did I do ? I started researching treatment options and doctors. I have exhausted all minimally invasive procedures from injection, branch blocks and RFA with no relief. I have had several opinions and until I found the one doctor that made me feel like there was hope, I continued to look. There is no way around my situation and so now I have come to terms with this and the doctor has given me hope for the first time in over a year.

    I am so sorry you are at the end of your rope but please know we have all been there too ! ANd in a blink things can get better ... if we believe they can ! Its hard seeing through the pain and trust me there are days I want to give up too, but my life is going to get better! I am scheduled for more surgery with a doctor that seems to have a good surgical plan. One that addresses all my cervical issues and I pray that this will be the end of this part of my painful experience. The surgery that I now have to have is tougher than the other two and the recovery is longer but that pain will disappear eventually. I will begin again a new ~

    Tracy~
  • It can take a year or more for fusion to take place. If you have the old bone growth stimulator, why not use it now?
    As far as what may occur down the road if the fusion does in fact fail, that would be best determined by your surgeon.
    Nerve pain typically increases for some time post op, and it can take quite awhile for it to settle down. 
    There are meds that help ease nerve pain, cymbalta, lyrica, gabapentin, topamax and some others.
    It is still far too early to be calling this surgery a failure at this point....fusion surgery recovery is lengthy, up to two years, and full of peaks and valleys.
    A second surgery complicates the recovery, especially if they were close together, before your body had a chance to heal properly from the first.


  • Traci...i am so so sorry. I cannot believe thay other ppl go thru this!! It is torture!! And my surgeon said what happened with the first one was less than 1% chance and this one is like unheard of. I felt like a freak. Im not sure if it makes me feel better or not that others go thru it too tbh!

    More surgery makes me want to vomit. I cant
     For so many reasons. Most of all is financial. I am a contract psychologist meaning i only get paid when i see clients. Ive pretty much been gone for a year. Im back now because we're about to lose the house. My husband left work to take care of me and is now looking for work but we could never sustain on his income. House is already in foreclosure so im trying to prevent all that from happening. Ugh.

    Sandi...it can take that long for a FULL FUSION to take place. I'm in no way talking about not being completely healed. Im talking about 0 bone growth. Like not even a dot on my xrays.  As i had already failed and broke a screw last year i unfortunately know the ins and outs of what a failure is. And bone growth stimulators only last 6 months. It doesn't turn on anymore.
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