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  • Can this really happen? Reherniation after fusion

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    Old 02-14-2011, 12:44 PM   #1
    storybkacres's Avatar
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    Can this really happen? Reherniation after fusion

    Hello all. I am new to this board and I'm hoping you guys can share some of your knowledge. I am too through with these back issues and just when you think you got it down, something else (painful) pops up. Below is my background on the lumbar fusion, kinda long but its there if you need it. The PM Dr. ordered an MRI in January- the summary results state that at L5-S1 I have left foraminal disc herniation causing left foaminal narrowing. My question is this, how in the heck can I have any disc herniation there when the disc was supposed to be removed during my fusion. When I read the report I couldn't believe my eyes and thought it was a mistake. I saw the PM doctor today and he confirmed the MRI results. While crying our of pure frustation I asked him if there was any reason WHY the disk was left in there. He doesn't know of any. This isn't just an itty bitty piece of disk-on the MRI film, its pretty much like the rest of them except this one is deformed because of the screws and plate. I asked what the process is to take care of this, and it was just as I thought. Start with the steriod injections and when they stop working, surgery. Any thoughts or experiences you can share would be greatly appreciated.

    After 3 years of having nerve blocks and steriod injections AND all the diagnostic injections, In 2006 I had a fusion at L5/S1 with the screws, plates , allograft and the bone growth hormone. All seemed to be well after the surgery-the major pain was gone, no more leg numbness, sciatica, etc. I still hurt, but at least it was manageable-I was satisfied with the outcome. About 6 months post-op I started having issues with the Left SI joint and approximately 3 months later the Right SI joint-I new this was a possiblity but never thought it would happen ( I was 38, with no prior back problems, worked all my life and very active). Nothing steroid injections and mild pain meds couldn't take care of. Overall I was happy with the fusion and my doctor. In early 2008 I started haveing severe shoulder pain and problems swallowing. After seeing a few ENT's for the swallowing issue and the ortho doctor (who couldn't find any reason why I would be having so much pain), I mentioned it to the spine Dr. when i was getting an SI joint injection. She pressed around my wing area (which caused excrutiating pain), did an xray on my neck and low and behold a bone spur pressing on my spinal cord. Needless to say in july of 2009 had a c5-c6 fusion which turned out to be a completely different nightmare. Anyway, late last year I started having severe lower back pain, sciatica as well as inflamation of both SI joints. When I went to the spine doctor (different from the surgeon) she sent me for steroid injections, which didn't work and since I shouldn't be having pain because I had the fusion she sent me to the pain management doctor, so hear I am. Thanks for listening

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    Old 02-14-2011, 06:12 PM   #2
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    Re: Can this really happen? Reherniation after fusion

    Welcome to the board.

    I can understand why you are confused! Were you told the disc was removed completely? In some types of fusions, the disc is only shaved off and the healthy part is left intact. Rods and pedicle screws hold the vertebrae in place and bone product, allograft, autograft...whatever the surgeon uses, is laid in along the "gutters." This material grows together and the disc eventually calcifies and becomes one with the vertebra on either side, resulting in the solid fusion. (At least that's how it is designed to work!)

    I don't know how your surgeon performed your procedure, but this might be one explanation for why there is still a disc in place. However, if your fusion was in 2006, I would think the disc would just show up as a mass of fused bone, if fusion took place as reported.

    You need to get more information. It is a curious turn of events. What did the doctor who ordered the MRI tell you about this??

    Last edited by teteri66; 02-14-2011 at 06:13 PM.

    Old 02-15-2011, 08:12 AM   #3
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    Re: Can this really happen? Reherniation after fusion

    Thank you for responding. When I was going to have the fusion it was explained to me that they would scrape out the disc, put in the cadaver bone with the growth hormone and that once healed (within a year) I would have a solid bone mass...although I never had another mri until january 2011, every xray i had showed progression of healing until there was complete whiteness (which was explained to me as bone growth) which happened at about 6 months. I thought maybe the radiologist made a mistake, I know it happens so I didn't worry too much. I looked at the pics on the CD, counted the bones, counted the discs and I didn't see the same whiteness/picture that I saw on the xray, but I'm not an expert.

    When I asked the pain management doctor about the report showing I had a disc herniation where I was supposed to have a fusion, he pulled up the mri results on the pc, guided me through the pics (L1-S1), showed me the plate, screws, disk, foraminal herniation, etc. and then told me he clearly wasn't a surgeon, but he was not sure why the disc wasn't removed. He did repeat this several times, considering I was in total astonishment and really couldn't believe my eyes or ears. When he started talking about injections to try and relieve some of the pressure, I think that was the point where I went into meltdown mode and really didn't hear anything else. He did give my husband his phone number to call for questions. The only thing I know is that I've been down this road and in my experience it leads to incredible pain and eventually to surgery and different pain/problems. Maybe I'm over reacting, I just don't know. I really can't believe this.

    So after all that ranting, can you tell me what type of information I would need. I thought about going to the original surgeon with the recent MRI/report, I'm just not sure I could handle that right now without acting like a raving maniac. I thought about having the surgeons office send over the operation reports as well as the mri taken before the surgery, but because the pain managment doctor isn't a surgeon I'm not sure if that's the right step either.

    Any information or advice you can provide would be GREATLY appreciated.

    Thank you so much

    Old 02-15-2011, 08:23 AM   #4
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    Re: Can this really happen? Reherniation after fusion

    Hi. I'm sorry for all the problems you are now faced with. I think I would make an appointment with a different Orthopedic Spine get another point of view and explanation. You could get a copy of the operative notes from the first surgeon to show to the new doctor, as well as the lastest MRI.

    It's extremely frustrating when we think we are "fixed" only to have a new problem crop up. Tetonteri gave you the information about how sometimes the disc is not completely removed, and that is probably the explanation for what is happening now.

    I do hope that you are able to find out what happened and what needs to be done to correct it. I wish you well and hope that you will continue to post and keep us updated.

    Lumbar surgery x 7 over the last 30 years.
    cervical fusion...2 levels
    medtronic pain pump implanted
    Last surgery Oct, 2010, 3 levels

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