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L4-L5-S1 3rd revision surgery diagnosed psuedoarthrosis again

Hi Everyone,

Quick back story on my situation. I'm 33 years old. I was 30 when I had my first surgery. In June of 2016 I had a L4-L5 fusion and a laminectomy. In october of 2016 it was discovered that my L5 pars were fractured and I was put into a body brace for two months. When that wasn't healing and the cage showed signs of movement it was suggested that they go back in and extend the fusion down to my S1 level. So I had the revison surgery in February of 2017 with a gill laminectomy. The whole time after the second surgery I was in horrible pain and my condition wasn't getting any better. My doctor had ct scans done in July of 2017 and it showed that the cages had moved and the hardware was lossening. Also no evdoesidence of bone growth. I was diagnosed psuedoarthrosis. It was suggested to have another revision fusion surgery from L4-L5-S1 with larger screws and the addition of bmp to help with the bone growth or have a spinal cord stimulator put in. I opted for having the third surgery cause I couldn't deal with the pain anymore and I didn't want to just mask the pain with the spinal cord stimulator.

So I had the third revision fusion surgery in October of 2017. It took over six hours to perform and then another six hours to get my pain under control in recovery. The whole time after having the third surgery I have not improved. Still having horrible constant pain all day everyday. Yeah the pain medication helps alot but that is not a perminent solution. My doctor kept thinking that I could be healing very slowly and that I would need a long time for recovery. Well we just had CT scans done in the beginning of December 2018 and it shows that the screws at S1 level are loosening on both sides and that there is no evidence of bone growth happening at all. Even with the addition of bmp my bones are still not fusing at all. I'm tired of being in pain everyday and not having much of a life due to mobility issues from the pain in my back that goes down my legs into my feet.

So with the recent ct scans showing the loose screws and no bone growth my doctor has suggested that I have a fourth surgery but do a 360 fusion this time with even larger screws and even more bmp this time. He also said or I can stay the way I am and get a pain management doctor. I just don't know what to do anymore. I feel like having a fourth surgery is such a gamble since the first three did not work at all and my body just does not wanna heal itself and fuse.

Has anybody gone through this and if so what did you end up doing. Would love to hear from anybody and everybody. 

I just can't believe i've been diagnosed psuedoarthrosis twice and nothing is working.

Thank you for taking the time to read my post. 

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Comments

  • The user and all related content has been deleted.
  • hvillshhvills Suzhou, ChinaPosts: 991
    edited 12/30/2018 - 3:52 AM

    James..

    I had to have a second surgery due to a failed fusion at L5-S1...  but 3 times failed fusion is horrible... especially at your age.  If I were in your shoes I would seek out a second or third opinion... even if you are confident with your current doctor... as there could be something he/she is over looking.  Maybe consult an othropedic specialist as they could possibly shed some light on why your bones are not fusing. To have a fourth failed fusion would be heart breaking.  If it was me I would really want to get to the root issue of why there is not any bone growth...  before they cut me open again.   Have you had a bone density scan... my doctors said my osteoporosis presented some cause for concern with my fusion screws possible coming loose due to the reduced bone density. 

    If/when you do proceed with the fourth surgery please talk to your doctor about taking Fosamax or something similar after your surgery to help with the bone growth fusion process.  Also you should talk to your doctor about any kind of NSAIDS you might be taking as these can sometimes interfere with bone growth. 

    I hope you find some good answers and clarity on your fusion issues.

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
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  • grtgrandma1aneeda70 Hi. Thank you for responding. Yeah, I need to get/find a pain management doctor. The first one I went to made me feel like a number (paycheck in his pocket) and not a person. The second pain management doctor I went to wanted to try an epidural shot so I agreed. That experience is in the top 3 of worse moments I've had dealing with this. That epidural shot made my pain 10 times worse for a week. I literally cried and screamed on the table for the pain management doctor to stop. Also my case is through workmans comp so it makes it a little more challenging to find a good doctor willing to work with ya.

  • hvills Hi. Thank you for responding and sorry to hear you had to have a revision surgery. They are not any better than the first one. I never thought about getting a bone density test done but I will ask for one. I have met with the chief orthopedic spine specialist as well. He actually over looks the orthopedic spine specialist I have now so maybe I will request to meet with him again as well. For some reason my body doesn't think it needs to heal the bones in my spine and thinks that they are fine on their own. Also epidural shot made my pain ten times worse for a little over a week too. 

    How are you doing since your revision ?

  • BitzicatBBitzicat PhoenixPosts: 74

    Your story really scares me.  If you are going through this and only in your thirties, I can’t imagine what your alternative would be since fusion eventually affects the spine over time in the area above and below the fusion.  I also have a failed fusion after two years.  Mine was really wierd  because I fused at 4/5 but not at 5/S1. My doctor wants to leave it alone.

    My recent Dexa was not good and I have been taking fosamex for two years!  I have not made a final decision about a revision; my hardware is solid for now but I know that will not last.  I do have lots of pain but an SI joint injection helped  to relieve some of it.  

    I too would like to hear from others who did not fuse and what they did about it.  Researching on Spine Health has not produced other cases that eventually were  resolved.

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  • BitzicatBBitzicat PhoenixPosts: 74

    One other thing I wanted to say....you have a very powerful headline; but even though it’s not very old, it’s buried in what I call “onesies”.  If you look back years there were long discussions about everything.  Now there is a lot of inconsequential gab in between important messaging.  A lot of good questions overlooked. I have been on here for two years and have given up several times because I don’t  get responses.

      Maybe the moderators could explain; Is it just me?

  • Bitzicat - Hi. Yeah I hear ya on messaging getting lost. I have a couple other forums on here from when I first started and they have gotten lost in the shuffle. I really wish I could get more responses or minds on here to discuss cause clearly we are not alone.

    As far as your situation goes sorry to hear your not fully fused. If I was you I would hold off on a revision cause you said you are fused at l4/l5 which in my mind would mean that the problem can't travel up since you have a solid bridge but that's my thinking. I could be totally wrong though too. 

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