bad news update
 

Hi Guys, I've just come from follow-up with my spine surgeon. The recent events were that I've had butt pain since about 3 months after laminectomy and fusion of my lumbar spine b/o a spinal cyst. An MRI and CT done last month showed arthritis at L5, below the fusion (new) and failure to fuse. The radiologist said I could still fuse. There was air around the screws, which he did not like, but said all was not lost; it's just not great.

Last Thursday I got steroid injections into the L5/S1 facets and joint space, which has taken some edge off the pain--I just can't sit comfortably. I can stand, lie down, but sitting hurts.

Today I saw the surgeon. He took one look at the MRI and said he is very unhappy with what he sees. It is the worst possible outcome. The three sets of screws are surrounded by air and that means, basically, they have come out. Nothing is holding them in place. There is zero fusion. No bone formed and healed where it was supposed to. He said when there's no bony fusion, there are two things which can happen. The rods can snap. Or, the screws can pull out. My screws have pulled out. And, there is now arthritis below the fusion, because, probably, there is a lot of shear force on the level.

He says nothing good will happen from here on. This is a "failed back with "pseudarthrosis". He says I do not have to worry about nerve damage---all the nerves from the lower spine have plenty of room, and nothing that will happen will hurt them. I won't get paralyzed or anything. However, over time I will have more and more back pain, as my back collapses on itself, and at some point I will decide to have a re-do. At that point, he would explore from the rear, repeat the fusion, then flip me over and do an anterior approach with hardware in the front of the spine. Since I have no risk factors for failure to fuse, whatever in my body caused me to not heal will probably still be present for the do-over.Therefore it would be prudent to do more hardware at that time, as well as extend the fusion down to S1.

He says to NOT do much exercise or physical therapy, as that will put stress on my back. (This doesn't sound right to me; I'm sure there are safe ways to exercise and stay strong). I only take oxycodone at night, because I work and need to be alert; he suggested that over vacation I allow myself to take it during the day, too, so I can sit and enjoy more. He said continue to get injections into the arthritic joint, or radio-ablation of the nerve supply to the arthritis, for some pain relief.

But, he says, there's no way I'm going to make it through life without a re-do. It's a matter of how long I can last without it and enjoy my life. He says to find a good pain doctor (I think I might have), and work with him as long as possible.

That's it. Sucks.

failed back- good news
 

I've done some reading, and I found an article following people who had not fused at one year. They gave them two hours a day with an external device to produce an electromagnetic field, and 68 % of these were fused by the next year.

It seems the process of fusion continues, and the trick is finding things that encourage the fusion.

I've asked my doctor to order me one of thsee, and he's agreed.

I'm back to feeling hopeful.

Also, the facet block worked, and the butt pain improved greatly. I had acupncture on friday, and got further games, and Feldenkrais on Saturday, adn after Feldenkrais, I sat for a couple of hours without pain. I'd not done that in a good 2 years.

Jane,

I am surprised that you were not given a bone stimulator...I suspect this is what you mean by a machine that produces an electomagnetic field? I wore mine 24 hours a day....I feel that even though my surgeon has stated that I am fused....I do not believe that I am...I have too much pain doing simple things.

I went for evaluation for PT last week and she noted that I was in too much pain for land therapy. I am doing aqua therapy now. My surgeon's PA would not agree to the aqua therapy, but I explained to the PT that my surgeon has never done an exam on me since the surgery. He does ex-rays and then sends me on my way...actually he doesn't, his partner does. He farmed me off on her early after the surgery. I like her though and do not mind seeing her. I saw him last in October. I had a CT Scan done, but the radiologist told me he could not read the scan. The surgeon told me he could and that I was fused. I do not believe it or else something else is wrong.

I had to get my Pain Mgt doc to write a script for my aqua therapy for me...My surgeon does not know that my legs are very weak...I saw a doc in Philadelphia about a month ago and he noted that there is great weakness in my legs. My toes on the left foot are weak and now sliding under the big toe. Cramping has returned to the legs and feet.

Maybe I will go to see your surgeon to try to determine what is going on with my fusion....I certainly would not want the hardware to break or a screw to pop.....Good grief!

Good luck...I am so sorry for your bad news....I certainly would not want to have to go through any of this again...I do not know that I could....

Gloria