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Can surgeon tell if back is fused postop?

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  • Can surgeon tell if back is fused postop?

    So, I am looking forward to my 6 month visit and hoping that I will learn if my back is fused. Can the surgeon tell by looking at the X-ray if there are any vertebrae that are fused? Also, can they see pseudoarthrosis?

    Susan, hoping for good news so at least only my front is falling apart
    Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
    2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
    2018: Removal L4,5 screw
    2021: Removal T1 screw & rod

  • #2
    At my 12 months checkup in August that was a question I really wanted answered by my surgeon, Dr. Lenke . He said he could not tell by the x-rays done at that time. He said a CAT scan would have to be done to really know and he said "I'm sure you wouldn't want that much extra radiation." I agreed but I was disappointed to not really know if I was fused. He said he was sure I was fused by that time.
    Jane

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    • #3
      They should be able to see fusion happening, but there's no test that will tell you with 100% certainty that a fusion is solid.
      Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
      ---------------------------------------------------------------------------------------------------------------------------------------------------
      Surgery 2/10/93 A/P fusion T4-L3
      Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

      Comment


      • #4
        I was surprised when my surgeon showed me the new bone on my 3 month visit. It didn't look like much, mainly in the lumbar, but he seemed happy with it. If I remember correctly, it looked like fine white lines.
        Surgery March 3, 2009 at almost 58, now 63.
        Dr. Askin, Brisbane, Australia
        T4-Pelvis, Posterior only
        Osteotomies and Laminectomies
        Was 68 degrees, now 22 and pain free

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        • #5
          Cool, Jennifer, I will look for the fine white lines.

          A corollary, can the surgeon tell if there has not been fusion and that there is non-fusion in an area? I still think about Gayle and her problem with broken rods and finally the surgeon said that she had 2 areas of non-fusion.

          Susan
          Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

          2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
          2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
          2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
          2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
          2018: Removal L4,5 screw
          2021: Removal T1 screw & rod

          Comment


          • #6
            Originally posted by LindaRacine View Post
            They should be able to see fusion happening, but there's no test that will tell you with 100% certainty that a fusion is solid.
            Susan, we all want to fuse since that is one of our goals but Linda is right here, they don’t know the integrity of the fusion mass and if I remember correctly from one of the meetings, that is really only known upon surgical intervention. Surgeons can go back in and find out that fusion really didn’t happen the way they want it to. Body chemistry plays an important part in all of this.

            My surgeon told me that I was fusing and showed me the white lines and spacer markers on my x-ray at 6 months. That was nice to see, and was released to do whatever, but I still took things easy since I really wanted a solid fusion. After walking on eggshells at 10 months he wanted me to kick things into gear and at 14 months “ordered” me to go skiing. I was very nervous about this matter....

            No falls, no jolts, no slips, no bending, no twisting, no tripping etc. This was on my mind and I wasn’t going to let this happen since my surgeries were so hard and didn’t want to ever go back in and repeat that agony ever again.

            I also was very nervous in the car....and yes, old Speed racer here slowed down quite a bit. Car accidents happen, but shoudn’t happen in our recoveries.....I didn’t drive unless it was totally necessary.

            In the end, it worked.....

            Please be careful, textbooks say bone takes 12 months to fuse, and 24 months to remodel.

            Ed
            49 yr old male, now 63, the new 64...
            Pre surgery curves T70,L70
            ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
            Dr Brett Menmuir St Marys Hospital Reno,Nevada

            Bending and twisting pics after full fusion
            http://www.scoliosis.org/forum/showt...on.&highlight=

            My x-rays
            http://www.scoliosis.org/forum/attac...2&d=1228779214

            http://www.scoliosis.org/forum/attac...3&d=1228779258

            Comment


            • #7
              Dr. Lenke showed me fusion on the 15 month post op xray and saw more fusion on the 22 month post op xray. The 1 year fusion pic is here http://bit.ly/1h7Wb4m
              44 years old at time of surgery, Atlanta GA

              Pre-Surgery Thorasic: 70 degrees, Pre-Surgery Lumbar: 68 degrees, lost 4 inches of height in 2011
              Post-Surgery curves ~10 degrees, regained 4 inches of height

              Posterior T3-sacrum & TLIF surgeries on Nov 28, 2011 with Dr. Lenke, St. Louis
              2 rods, 33 screws, 2 cages, 2 connectors, living a new life I never dreamed of!

              http://thebionicachronicles.blogspot.com/

              Comment


              • #8
                There is a difference between being able to see fusion on xrays (or other tests), and being 100% fused. It doesn't happen all that often, but there is really nothing (not even exploration) that will guarantee that you don't have a microscopic break in the fusion mass. In the end, it really doesn't matter, unless one plans to spend the rest of their life not putting any stress on their torso. If there's a microscopic break, it usually can't be seen or detected. These patients will go on to eventually fuse, or a rod will eventually break. Either way, the fix is relatively easy.

                --Linda
                Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                ---------------------------------------------------------------------------------------------------------------------------------------------------
                Surgery 2/10/93 A/P fusion T4-L3
                Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                Comment


                • #9
                  So much for wanting some kind of reassurance....
                  Susan
                  Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                  2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                  2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                  2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
                  2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
                  2018: Removal L4,5 screw
                  2021: Removal T1 screw & rod

                  Comment

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