Re: 2 Years post Surgery Now getting worse
Welcome to the board. So, other than his concerns about your continued drug use, did he examine you or talk to you about the accident, or talk about getting any imaging done?
Since you had your fusion over two years ago and you are still in pain, if the surgeon isn't addressing your concerns, I would suggest you consult with a new spine specialist. When you feel like you're in a rut with the current surgeon, it can be helpful to see someone who will be looking at your case with "new eyes."
I've noticed that doctors tend to go with the most obvious issue and don't seem to take into consideration the "secondary" issues that might actually be the cause of pain. When you go to a new doctor, he realizes that the patient is still in pain after whatever was first done, so he/she looks to see if there is an issue with the first procedure and whether something new has developed, perhaps as a result of the first procedure...or whatever else might have developed.
I don't know enough about your situation to comment about you in particular, but, in general, a surgeon doesn't follow a patient beyond 12 months unless there are ongoing issues. If those issues are being managed with medication, the patient is usually discharged to his/her PCP or to a pain management doctor. The surgeon's expertise is not in managing a patient's ongoing pain.
In your case, since you had the car accident, it would make sense to me to at least investigate to see if a new MRI is warranted. The problem with any car accident is the sudden impact that the body is subjected to. Unfortunately this often causes a patient to develop arthritis sooner than he/she might otherwise. I would think at the very least you would want an x-ray of the fusion to be sure everything still looks intact.