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Lumbar Fusion Failure...

hvillshhvills Suzhou, ChinaPosts: 995
edited 08/15/2015 - 9:56 PM in Back Surgery and Neck Surgery

has anyone experienced a fusion failure..???

i’m 62 years old and in may of 2013 i had a double level fusion surgery (plif l4-s1) due to severe disc degeneration and spinal stenosis that did not respond to the various less invasive treatments. in the surgery they did the normal decompression, rod and screws bit, and a full laminectomy on l5 and a partial laminectomy on l4. it took almost 12 months before i felt completely normal again but there were no particular complications or issues. that is until month 18… when one day while out walking i noticed a strong pain in my lower right leg. this was something i hadn’t experienced either before or after the surgery. within a matter of days this pain grew much stronger and spread the full length of my leg starting at my right hip and radiating down the front of my thigh and down to my feet to the point that i could barely walk to the bathroom without crumpling over in pain. i believe this is commonly referred to as sciatic pain.

after doing various x-rays and scans the doctors concluded that i had a herniated l3 disc and that it was badly crushing my spinal cord… and was the source of the sciatic pain. they also discovered that one of the screws in the l5-s1 fusion had broke and the alignment of l5 and s1 has slipped. in-short the fusion had failed… despite all follow-ups and imaging over the previous months had showed the fusion was “ok”. in january of this year they had to go in a redo the l5-s1 fusion from scratch… in addition to performing decompression, discectomy and a partial laminectomy on l3-l4 to resolve the sciatic pain issues.

despite my repeated requests the doctors offered little to no explanation as to why the screw broke and the fusion failed. is this a common occurrence for fusion surgery? what i can find/read on-line doesn’t seem to give a clear answer. has anyone else out there in spine- health experienced a fusion failure and had to have a second surgery? did the doctors give any explanations???

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


  • LizLiz Posts: 9,699
    please take the time to read this post and refer to it when you have questions

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    Veritas-Health Forum Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
  • dilauroddilauro ConnecticutPosts: 12,571
    those not so good.

    I have always encouraged patients to get their surgical records after any spinal surgery. Those records will contain medical facts about the exact surgical procedure, what was done, what was not, patient stability, etc.

    Everything that anyone needs to know about the surgery will be contained in those records. You may never need them, but it seems it a situation like yours, having that data might be helpful in any legal matter you are looking into.

    There are follow on test ( new mri for example) plus other information that should be collected to produce a complete set of medical data regarding any surgery. For example, with a follow on mri (lets say at 6 months), you would have found out that you did not fuse.

    Everyone is entitled to obtain copies of their medical records. They may be a slight charge for this ($1/page) but these are legal documents , and hopefully you only ever need them to review the situation.
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  • Sorry to hear about the failed fusion. Unfortunately it does happen though. Many doctors don't like to admit to failures for fear of litigation so if in doubt about anything it can't hurt to get a second opinion. The issue with the herniated disk at L3 is not uncommon and is a possible outcome that your surgeon should have warned you about. It can happen because the lack of movement at the levels below put more pressure on the disks above the fusion.

    My own story of failed fusion is not something that is often seen but at least my surgeon was up front about it. In my case - I had a fusion via TLIF at L4/5. All appeared to be well with the fusion side but a serious issue with medication shifted the focus off the spine and on to medication management. I was in the hospital for 2 weeks while the doctors worked on finding a pain management plan that my body could cope with. On the day I was released the doctor on the ward realised I hadn't had a follow up image on my spine that had been ordered about 9 days earlier so he arranged for it to be done before I went home. Only trouble was - no-one looked at it. If they had I might not have had the problems I ended up with.

    The image showed that the cage had slipped through and was hanging out the front of my spine. It was still between the vertebrae but only just. This issue was finally picked up in a follow up scan about 3 months down the track. At this point the surgeon thought it best to wait and see whether the small amount that was still in there would be enough to allow a fusion to happen. After about 10 months he decided it wasn't going to and he became concerned that it could actually shift further out and cause more damage. Upshot - more surgery. This time to fuse the level below for added stability and to remove and replace the offending cage.

    Surgery this time was ALIF because the only way to get to the cage was through the front. Vascular surgeon helped to clear the path because the aorta and vena carva lie in front of the spine at that point. Should have been easy but no ... The wait and see approach allowed scar tissue to form and the scar tissue had caught the aorta. Upshot - aorta torn three times before vascular surgeon decided he wouldn't be able to patch another tear so he couldn't clear a path to allow neurosurgeon to remove and replace cage. Could clear a path to the side so that offending cage could be removed but that was it.

    Now - 3 years later - no cage, no fusion at L4/5 but some promising signs of bone growth. Unfortunately some of the bone is growing where we don't want it and starting to compress nerves on both sides to so my near future will involve further surgery to remove the offending osteophytes and make more room for the nerves to pass freely.

    So - in answer to your question - yes. Fusions can fail for a million and one reasons. Revision surgery is often needed as a result. It is not always the doctor's fault - sometimes thing just happen. You need to feel trust that your doctor has your best interests at heart - if not - find another doctor. In my case, had I not had all of the other complications while I was in the hospital the surgeon might have picked up the problem straight away and he might have been able to fix it straight away. But hey ... That's life!
  • hvillshhvills Suzhou, ChinaPosts: 995

    Regarding a follow-up MRI my doctors say that because I have stents in my heart that they cannot safely do an MRI.

    Does that sound right to you..???

    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
  • I had a failed L5-S1 fusion. PM me if you want details.

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