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    Old 05-04-2006, 05:26 PM   #1
    Suzy-Q
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    Why Exactly does a Failed Fusion Hurt?

    Hello -
    I'm wondering if anyone has ever been told or read just why a failed fusion (with hardware) hurts? Is it because things are moving? Isn't the hardware supposed to prevent movement? I have a failed fusion. I have been sure there is something wrong with my hardware and fully expected a new c scan to show the L4 left screw to be loose or bent or ... something! Well, reports are in and it all looks fine. So, why do I hurt. I am bolted in place, right? I'm just curious to know if you all have been told what the physiological explanation of the pain is? I should add that my surgeon says I do not show signs of significant disk problems or stenosis. And now that it looks like my hardware is good I'm puzzled as to what all this pain is from. Thanks - Suzy-Q

     
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    Old 05-04-2006, 06:23 PM   #2
    sheri42
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    Re: Why Exactly does a Failed Fusion Hurt?

    I am only 11 weeks out from 2 level but have wondered the same thing. They say if you are getting better than you are fusing. If you get worse than your not. Well how do you get worse because when you leave hosp your not fused. You just have the hardware holding you in place, so why does it get worse than immediate post op??? Not sure??? I had grade 2 spondy so after I got hardware I felt immediate stablization and no movement pain. Even if I dont fuse wont that movement pain stay gone because of hardware holding me now? I know I am not helping you. I am just on the same page is all.
    Sheri

     
    Old 05-04-2006, 11:17 PM   #3
    daldridge
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    Re: Why Exactly does a Failed Fusion Hurt?

    I've been going thru pain for the last two years after back surgery. I have hardware and have fused just fine but they did a discogram and discovered mu hardware is pressing against the nerve root...thus the pain. Now I have to have my hardware removed!

    Last edited by daldridge; 05-04-2006 at 11:18 PM.

     
    Old 05-05-2006, 05:39 AM   #4
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    Re: Why Exactly does a Failed Fusion Hurt?

    Just found out by workers comp doctor that my fusion is not healing at all after 5 months ,this is comming from a guy who is supposed to be out to get me ? My surgeon told me it was fusing ? Here we go again...wish they would be straight up with me.

     
    Old 05-05-2006, 05:56 AM   #5
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    Re: Why Exactly does a Failed Fusion Hurt?

    Hello,
    This is a tad off topic, but I'm wondering Sheri42 (or anyone else!) if you could write more about how you felt with the spondy 2 prior to your fusion? You mentioned the pain with movement, but did you feel that your back was not stable? I've been told by 2 spinal specialists that I need to have a one level fusion due to stenosis and spondy. I don't feel that I am "bad enough" to have what sounds like drastic surgery. Could you describe more how you felt prior to your surgery? Thanks.

    Cynthia

     
    Old 05-05-2006, 06:05 AM   #6
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    Re: Why Exactly does a Failed Fusion Hurt?

    tsohl, the pain I felt before my surgery was horrible, my back felt tired and hurting like crazzy , unless I was on my back. You will know when it's time to do the surgery , when you feel like doing nothing because of the pain ,it's time.
    Sorry I might not have the answer your looking for ?? Hope your feeling better

     
    Old 05-05-2006, 08:16 AM   #7
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    Re: Why Exactly does a Failed Fusion Hurt?

    Hello,
    I was diagnosed 9 yrs ago with spondy grade 1 L5-S1. About 2 months later I got pregnant with my 3rd child(accident) I was afraid of how this would effect my back. I made it through the end and he weighed 8.5 lbs. Went for mri after and I was still a grade 1. The pain over the next 4 years progressivly got worse.

    In 2001 My L4 disk started to bulved and I began to slip to a grade 2 between 2001 and late 2005. Before I had my fusion I couldnt stand more than 5 minutes, cook, vacuum, sit long, everything was starting to close in on me in about 5-8 minute time frame. The movement pain that I felt, it was a pain that happened when I sneezed,bend,stand,laugh or just about anything. I never knew it was movement pain until I got hardware put in. The first thing I noticed in the hospital was how stable I felt. I really felt tight and put together. Funny, that I never felt un put together before surgery.

    They always talked about instability and stuff, but I never knew just how unstable I was until I was stablized. I told my hubby, it is soo weird that you people have had this your whole lives. He laughed at me. I was truly amazed at the difference in how I felt with the hardware. My posture was horrible because I was always compensating for my lumbar being unstable so my upper back hurt all the time just everything was messed up.

    After surgery, my upper back quit hurting, all my family and friends have noticed that I sit and stand up straighter and I grew an inch. I am 11 weeks post op L4 -S1 TLIF with common post op recovery issues.

    One more thing,
    If I had my choice TODAY, I would have done a 1 level L5-S1 fusion and not waited but 9 years ago the technology wasnt what it is today and I waited till I was bone on bone and therefore L4 degernerated and had to be fused. I really beat myself up for that. I believe if you fuse L5 you can sometimes go 15 or 20 years before your next level goes. It is also very deep in your pelvis and you dont notice loss of movement. L4 is a very movement dominent segment and I dont think I will get by even 10 years before L3 goes but what do I know???? Good -Luck.
    Sheri

     
    Old 05-05-2006, 04:46 PM   #8
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    Re: Why Exactly does a Failed Fusion Hurt?

    [QUOTE=shawley]Just found out by workers comp doctor that my fusion is not healing at all after 5 months ,this is comming from a guy who is supposed to be out to get me ? My surgeon told me it was fusing ? Here we go again...wish they would be straight up with me.[/QUOTE]


    My son's doctor has danced around this fusing issue too. The xrays do not mention fusing nor does the CT scan. He's 12 months out since his surgery. The last appointment in April his doctor said everything looks good and is in place and that you can't really tell for absolutely sure if it's fused unless you go back in and look, but it looks like he's fused. Yeah! Yeah! Yeah!

    I did read somewhere on a web site like Spine Universe that even if you don't fuse, as long as the pain is gone that's what's important. My son still has problems, but I wouldn't say it's major pain. So, who knows if he has fused?

    Bobi

     
    Old 05-05-2006, 06:00 PM   #9
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    Re: Why Exactly does a Failed Fusion Hurt?

    Thanks to All for Pitching in with a Response-
    This bad back business is a heck of a thing, no? Just when I think I understand the biology of whats going on soemthing comes up or is said that starts to germinate and a bit later I'm baffled-again. But in the end it is the pain and debility that decides the issue. I am eternally grateful that I am not having the nerve pain that so many others are dealing with. But my own discomfort is as much as I can manage. I am able to keep working and that is the crucial thing cuz I have excellent medical coverage and an excellent union that will allow me to go to a communal 'sick bank' to receive time from other employees. FMLA will protect my job but it would be leave without pay since I used all my time last year to have my first fusion. This past year, my earned time has been nearly totally eaten up with PT, drs apts, MRIs and such. I have booked my revison surgery for June 29th exactly because I will be eligible for the full 12 weeks of FMLA leave on June 23rd. But my own leave hours will cover less than 80 of the 450 hours I will be out (and this is if things go great!). My goose would be cooked if it weren't for the employee sick bank. As it is, my co-workers and friends will be able to donate time to me to get me through. I'm so glad that I have been such a brown-noser! Half-jest, full earnest. This system really brings home to all of us that we are indeed a community and by working together we can accomplish what we could not otherwise. At 42 and now 43, I never expected to be a recepient of hours. I'd love to be a donor and I do look forward to the chance to be just that. I just don't know how others get by and my heart tells me that some - don't.
    Well, I'm not sure where all that fits into this thread but I think the booking of my surgery has brought home to me just how many advantages a back surgery requires. I'm going to have my surgery in Boston and 2.5 hrs from home. We're booking a room for my husband to stay in for the first several days and I am looking into a paid ambulance ride home or some such thing. All the time I think, and what if I just couldn't write a check for all of these expenses? Humbling.
    Well, I guess I don't know for sure why I hurt. My surgeon describes my situation as unstable. The hardware is 'good' but the back is unstable. OK I guess that will have to do. Thanks for listening - Suzy-Q

     
    Old 05-05-2006, 09:05 PM   #10
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    Re: Why Exactly does a Failed Fusion Hurt?

    Hey SuzyQ,
    I dont know why i seem to gravitate to your posts, but as far as the ride home from surgery, mine was a 3 hr. ride after two surgeries within 4 days of each other. I thought I was gonna die just hinking of it. The ambulance ride would have cost close to 1,000 for me my Dr. said and no ins. will cover it unless you need medical care while in transport. Well rest assured, it was no worse than being in that darn hospital bed. I reclined the seat all the way, they gave me my meds when I got in car, a hershey kiss from favorite nurse, she'll never know how i needed that. I even fell asleep for a while. The key was to get out of car a few times, it was hard but I wasn't stiff that way. NOw i'm not gonna kid ya, when I got home I almost held the pharmacist hostage for my scripts to get filled as fast as they could , lol. But it was no way as bad as I imagined.

    As far as the failed fusion thing, mine was the screws wiggleing when i moved I could draw you a picture of them I felt those screws that bad when I would move. Now my second failure was with no hardware, it didn't really hurt until the nerve was getting compressed due to the grade 2-3 spondy. Actually it was 5 mo. post op when things started to move, we really thought it was fusing till then. Just my experience ,hope it helps. Good luck again !!!

    Carol
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    Old 05-06-2006, 04:45 AM   #11
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    Re: Why Exactly does a Failed Fusion Hurt?

    hi guys,

    im having a fusion soon for spondy grade 4/5! but my surgeon hasnt mentioned anything about using hardware, he says all he will need is bone graft....
    are failed fusions common?

     
    Old 05-06-2006, 07:36 PM   #12
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    Re: Why Exactly does a Failed Fusion Hurt?

    Evening Stud89-
    Spondy grade 4/5! Good grief, mine was grade 2 and I was nearly driven mad with the slipping and the electric current -like pain! I can't even imagine what you're going through. Failed fusions? Hmmmm.... Well, depending on the surgical approach taken (interbody and posterolateral fusins as opposed to just a posterolateral fusion and so on) and the source you're citing, failure rates range from 14% to close to 40%!! This certainly gives us reason to pause but I think it is really important to remember who you are talking to on this board - those of us with chronic and complicated problems. The majority do fuse and are out dancing! I was diagnosed in Jan of 2005 after a year of symptoms. I was astonished when I went for my first orthopedic consult. I expected to be told to use more ice, try yoga and a few epidurals. Nope, I was told I needed surgery- perid. Second opinion added that I needed surgery sooner rather than later. I was quite flabbergasted. I had been told by so many frinds and relatives that surgery is never done until you're half dead and here I was being told 'surgery' as soon as they set eyes on my films. Once I had done my research and really understood my condition I had to agree - my problem wasn't going to go away or improve. I knew I had to try to get better. My fusion failed. I don't know why. And my lumbar situation is even more unstable than it was to begin with. Unbelievable enough, I'm going to have to try again. No way am I giving up this fight without another whack at it. That's my story, Stud, and I do hope you read plenty of others- they will help you find your way. As for hardware, I was told that because I was going to have L4 decompressed it would further destabilize and the hardware would be necessary to keep things in place until the autograft created a complete bony fusion. Also, since I had spondy with slippage I needed to have the hardawre to hold L4 in a correct alignment so it would fuse in a corrected position. I remember being told that if 1) I didn't have such severe stenosis, and 2) they could not repostion L4 then they would not have put in the hardware. Perhaps your surgeon does not think your vertebrae can be forced into a proper alignment and feels it needs to be fused at near its present location? From what I read, that may be fine so long as it does fuse and no nerve entrapment or impingement is present. That's the long of it. Best of luck.
    Hi Carol - It is always a pleasure to chat with you and I posted on your thread with my heartfelt concern for you. Gosh, you always make me laugh - holding the pharmacist hostage! LOLOL. But it is funny you mentioned it because...... I keep a few pain pills for just that situation. It has been my good luck (!) to have had 4 fairly minor surgeries in the last 4-5 years and, of course, my fusion surgery last year. I have been cheerfully stuffed into my car and told the ride should be no 'biggie' and breezily told to fill my Rx after I get comfy and settled in. All well-meaning but dead wrong in all cases. I have had perfectly miserable ordeals and hold ups at the pharmacy and all manner of delays. Never again! If I am not given sufficient pain medication or a delay occurs - I will take matters into my own hands, literally. Well, I should stop before I crash the internet with this huge post. Thanks to all for chatting - there is no substitute to talking with your true peers. Suzy-Q

     
    Old 05-10-2006, 04:10 AM   #13
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    Re: Why Exactly does a Failed Fusion Hurt?

    Stud , 4/5 ? Do you mean L4-L5 ? I never heard of spondy 4/5. Anyway good luck on your surgery there never any fun .

     
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