L4-L5-S1 3rd Revision Surgery Failed 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. 



  • memerainboltmemerainbolt IndianaPosts: 3,419

    I am so sorry. Not just what you have been through but what you are facing, the decisions alone are enough for any one. |
    Any surgery is a gamble. I would talk with your surgeon more and ask more questions. But more than anything, listen to your heart and your body. Do what is best for you. If you decided on pain management (PM), before you sign a contract, ask a lot of questions. We have several good articles on PM I can send you if you would like. There have been other members with failed surgeries, I hope they reply.

    Take care and don't give up. Keep a positive attitude and let us know how you are doing.

  • Memerainbolt Thank you for responding. I'm gonna ask my doctor about getting a bone density test to see if that is possibly contributing to my bones not fusing. I just don't know if I will benefit from having a fourth surgery in the same location when the first three didn't work at all and only caused more complications and a lot more pain than I've ever had. I really wish I would hear from more people on here. Would really like to hear some their stories and insights. Again thank you for responding.

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  • I'm in same situation with having failed fusions,2 in lumbar & one cervical,both have broken screws & no bone growth. I found out years after once I went to another DR because of the pain & being accused of seeking pills. My cervical is horrible pain & like you looking for answers,I wish I had found out sooner so they could have tried a revision. One DR told me that I'd have to do lots of supplements,eat high protein diet & had lower my body PH as was acidic from lots of the stuff I used to eat.

  • Wnclee Sorry to hear that. How long have you been dealing with broken screws? If your able to have a revision now it might help. See for me I had two revisions in the same spot with no better outcome.Thats why I don't know if a third revision/fourth surgery would do any better.  Back pain is no joke. 

  • My intention with this comment is not to try find a way to blame you, JtD85, for your lack of success with obtaining a fusion. But I'm just wondering if you tick any of the things that negatively affect obtaining a solid fusion: 

    • Smoking (nicotine)
    • Obesity
    • Osteoporosis
    • Chronic steroid use
    • Diabetes Mellitus or other chronic illnesses
    • Prior back surgery or attempted fusion
    • Malnutrition
    • Post-surgery activities

    Obviously you tick the prior back surgery / attempted fusion, but what about the others? 

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  • jtD85

    I am sorry to hear about your troubles, especially at such a young age. I have had 3 fusion surgeries and consider myself very lucky that I fused very quickly after all of them. Have you discussed your situation with another surgeon to see what they recommend, sometimes another set of eyes and ears can be a good thing. I wish I could offer you more support, but as others have said surgery has to be your decision and yours only, and I can understand what a tough decision that can be. Good luck and keep us posted on your progress.


  • BitzicatBBitzicat PhoenixPosts: 64

    I am 2 and half years post fusion L4/5 S/1.  Fused at 4/5 but not at S1. Dr says everything secure, just do everything you can (which is not much).  I have constant pain at the S1 level.  My bone density test was not good.  I’ve been reading about non-fusion and believe I would still not fuse if I had a redo.  I think it has something to do with nutrition.  Even taking  Fosamex, while building bone density pulls calcium away from the bone.  How does that make any sense?  

    JTD, your story makes me even less eager to get another fusion.  I wonder if someday the hardware will just break.  

  • Timsdeece No to all of that. Now I've definitely gained weight since having these 3 surgeries due to immobility even with watching what I eat and how much. Only so much movement can be done before it becomes too painful to move at all unfortuantly.

  • Challenger That's great that you have had a successful outcome. I have had a discussion with another surgeon and his recommendation was the same. To do a 360 fusion to see if that works. I still to this day do not know how I feel about having that surgery done.

  • Your in a tough situation, being in pain everyday wears you down, but the decision to have more surgery is a hard one.


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