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    Old 08-19-2009, 11:11 AM   #1
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    Questions about fused bone

    Hi all!! I was wondering if once the bone is fused, can it come un-fused?? I had a ACDF in Nov 2003 for C5/6 - C6/7. In the past 5 1/2 years, I have been to numerous doctors, pain centers, neurologists, neurosurgeons complaining that I still had unbearable pain. I have had x-rays, MRIs, cat scans, epidural injections, rf ablations, trigger point and facet joint injections along with physical therapy and so on and so on and so on....Every one of these doctors has told me that there was a solid fusion. I had a chest xray in July of this year that showed that the plate in my neck was broken. I went to my current neurosurgeon and he ordered a cat scan. He said it showed that C6/7 is not fused. How can this be if it was solidly fused before??

    I had a discogram on 8/12/09 which also showed that now C4/5 needs to be included in the fusion. The NS will take out the hardware and refuse. I will be having the surgery sometime in September.


    C5-6 / C6-7 ruptured Nov 2003
    Cervical fusion December 2003
    Diagnosed Deg Disc/Joint Disease Jan 2004
    Right Rotator Cuff repair April 2007
    Lumbar Fusion L4-5 / L5-S1 May 21, 2009
    Left Rotator Cuff repair July 7., 2009

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    Old 08-19-2009, 03:48 PM   #2
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    Re: Questions about fused bone

    Did any of the previous tests you had taken include a CT? If you had only had Xrays taken to confirm your fusion, that could be the culprit. Because an Xray only shows a 2-dimensional picture, the entire depth of the bone is shown in one picture, so even a very small turn or twist in your neck can obscure the image between the vertebrae. I had Xrays taken several times and my previous surgeon didn't see anything wrong, but it wasn't until my pain doctor ordered a CT scan did we find out that I wasn't fused. The CT gives a 3-D picture and will clearly show if the bone has grown or not.

    I was surprised that it took my doctors a year and a half to find out for me, but 6 years? If this really is the problem, that is really a long time to suffer from all that pain when there was a simple answer. I bet it's pretty frustrating.

    I am only 6 weeks out from my new fusion surgery and my new surgeon is already ordering a CT for 5 months out because it does show fusion activity so well.

    Old 09-05-2009, 10:56 AM   #3
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    Re: Questions about fused bone

    I also had the same surgery as you ACDF C5/6/7. Cadaver bone and titanium plate with 4 screws. I had my surgery in November of 2005 in NYU Hospital in New York City. I feel fine now. I was able to go to the gym after 3 months. I had full trust in my surgeon. He is now retired. He saved my life. I have also had Xrays to see if any plate or screws have broken. They have not broke and my new neurosurgeon in Florida says the fusion is perfect. I truly wish you well. I truly believe it depends on the surgeon. Its a gut feeling. I knew he was the guy. He was in his 60`s and he was the President of the USA Neurological Surgeons Society. FYI...My surgeon told me that if the instrumentation ever broke or cracked it should not be a problem as it is no longer needed once your fusion occurs. I really feel for you. PLEASE follow up and let us know how you do with your next surgery.

    Old 09-06-2009, 10:37 AM   #4
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    Re: Questions about fused bone

    honestly? unless they actually did what is called a flexion and extension type of x ray on you back then that SHOWED how the boney prominences actually moved at the very back of your spine that should just appear a very specific way if you are indeed fused, there seriously is no real way to actually truely know for certain whether you were or were not even fused back then. espescially with hardware.

    i had my first surgery(fusion) done with no hardware. despite the fact i could feel things kind of grinding and knew things were moving just based upon intermittant numbness and tingling and pain that would just pop in and out on me, my NS told me i was fused. tho my primary and myself knew otherwise just based upon what we both could hear going on with the snap crackle pop everytime i moved my neck a certain way. so we finally got an MRI which came up inconclusive and recommended a CT. well that CT almost sent me over the edge since it stated there was no doubt that i was actually fused, when we just knew there was NO freaking way that that was true based upon my recurring symptoms alone. it was not until after nine months of living hell that my NS decided to send me for that very simple type of x ray and the boney promences that should have stuck together in a specific area if this was fused, all fanned out perfectly upon the film and extention and flexion that he FINALLY declared my c spine unstable/non fused and scheduled my hardware placement surgery like immediately? there is also a bit of gapping that can also be seen right at the so called 'fused' endplate within the column that shows too upon this type of x ray that would indicate non fusion. even WITH hardware there since things just show themselves so very clearly upon x ray, it would be detectable with this simple type of x ray. i just wish the stupid NS would have done that dang x ray at the very beginning when i told him about all these symptoms that were ALL indicative of non fusion.

    the thing about your situation is i would think if this were indeed a solid fusion to begin with that the chances of actually even breaking that plate would have been pretty darn slim considering that there would have been no real give or even any 'play' in that area if it was indeed a solid fusion to begin with, ya know what i mean? but if even one endplate did not take or actually fuse,there would have been "allowed movement" that over time that would have just stressed that titanium over time til it just gave and cracked on you. my plate and screws are just fine and have no cracks or problems and i now know with 100% certainty that my fusion did finally take back by 2003 only because my new NS, when they had to do my spinal cord surgery, actually visualized it with his own eyes and told me he saw it and it was perfect. otherwise i would still kinda wonder ya know? ya can't beat having an NS actually 'see it' to know how well a fusion went.

    i really don't think you will ever actually know at this point just what or what was not actually fused back then. most types of tests except for having that type of x ray done(espescially at the c spine level, it just shows that well there), just really cannot give you a true SOLID real dx of it. they just can't. my own experience showed me that and since then i have seen others post here and know others who went thru the very same type of thing. getting a "fused" when it turned out there was not one, or as in my case, i only had one endplate that fused and not the other. but the mere fact that you have had these unrelenting types of symptoms since that surgery was actually even done really tells alot right there ya know? my pain and radiculopathic symptoms actually were ten times worse after a few months post op form that first surgery than they were when i actually first walked into my NSs office. hopefully once this next surgery gets done things will get tons better for you. just make darn certain that they just actually do that flex and ext type x ray before they just 'pronounce" you fused this go round. it really is the best type of real test that shows fusion in the best ways. MRI and CT just cannot show the very detailed and specific types of areas upon flex that this simple x ray can. i do wish you lots of luck with this. sorry you have to even go this route again after everything else you have been thru with just your c spine. please let us know how you are doing. marcia
    3-22-01,herniated C-6-7
    11-20-01,placement of hardware for failed fusion
    9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

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