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Thread: Is it possible that fusion didn't work?

  1. #1
    Join Date
    Aug 2012
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    Is it possible that fusion didn't work?

    Hi everyone,

    I haven't posted in a while. I had my surgery last November, T3-L3 to reduce my top curve from 58 down to almost 15. The surgery went very well and overall I'm feeling pretty good. Daily aches and pains and still using Ultram but Im staying active with walking and gentle yoga. I had a herniated disc too and that seems to be getting better. After the surgery I remember looking in the mirror and being so happy to see my top right hump almost gone and noticing how much more evenly my shirts lay across my chest. Maybe I'm going crazy but I feel like the hump is getting bigger again. I have my 9 month checkup next week and am going to ask my doctor to take another X ray which he would probably do anyway. Perhaps its just paranoia, but after everything I went through over the past 9 months, I'm praying the fusion worked and everything is OK. I have 2 rods and 22 screws. Is it possible things could shift around or the fusion didn't work? Any feedback is appreciated.

    Thank you!

    Jill

  2. #2
    Join Date
    Mar 2010
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    Jill,
    I am not by any means an expert. But this is not the first story I've heard about people's appearance changing from immediate post-surgical to later on. I don't have an answer to what causes that. But, like I said, I've seen it before. It is possible that a fusion doesn't take at every level. It's called a pseudoarthrosis. It requires revision surgery. However, you are only 9 months out. I think they give you a year to fuse. But I could be wrong. If you are young, you have age on your side.

    You are right about requesting new x-rays when you go. You can compare them to your x-rays right after surgery. I'm sure you doctor will be able to answer your questions when you go. I will warn you that you can't always see a pseudoarthrosis on x-ray. You can also ask your doctor about that. In fact, I would suggest writing a list of questions with the most important questions on the top and the least important question on the bottom just in case he doesn't have time to answer them all.

    Please let us know how your appointment goes. Best wishes.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  3. #3
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    Aug 2012
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    Thanks rohrer01. I will ask for another X ray to compare from after surgery. It might just be in my head...Im hoping. I just wonder once the rods and screws are placed in, does that truly mean that the curve wont increase at all? What are the chances of it increasing. I was told the chances are very low. The rods are placed in to correct the curve but also to help prevent it from increasing. I'll definitely post again after my appt next week.

  4. #4
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    Hi there,

    I think it is really common for the curves to "settle" a little and the appearance of the back to change somewhat over time. It doesn't mean anything is wrong with the fusion or the hardware. This definitely happened to me. I would try to not worry too much, and ask your surgeon about it next week.
    Gayle, age 50
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    2010 VBS Dr Luhmann Shriners St Louis
    2017 curves stable/skeletely mature

    also mom of Torrey, 12 y/o son, 16* T, stable

  5. #5
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    Apr 2012
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    San Jose, CA
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    571
    Hi Jill,

    My back appearance changed a little too since the surgery. Like you, I was paranoid and looked at mirror every single day. All my x-rays were normal and the doctor said fusion looks good. I think, part of it might be change in weight. I lost a lot of weihgt after the surgery and looked like a skeleton. Now, I gained my weight back... I am actually a little heavier than before the surgery and may be that little increase in hump is just fat that I didn't have right after the surgery?
    I am stronger than scoliosis, and won't let it rule my life!
    45 years old - diagnosed at age 7
    A/P surgery on March 5/7, 2013 - UCSF

  6. #6
    Join Date
    Sep 2003
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    Northern California
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    This is something I've heard a lot, but I haven't actually seen anyone who has had surgery in recent years, whose rib humps were significantly larger at follow-up. It could be that certain techniques allow the ribs to re-rotate somewhat, or it could be perception.
    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

  7. #7
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    Jan 2012
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    Yacolt, WA
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    My kyphosis was pretty much resolved by the surgery, but I now have a kyphosis in the cervical area. I do not like how it looks, but so far I have little discomfort.

    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe 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 Spinal Cord Injury T4,5 sec to PJK
    2015: Revision 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

  8. #8
    Join Date
    Mar 2010
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    Quote Originally Posted by susancook View Post
    My kyphosis was pretty much resolved by the surgery, but I now have a kyphosis in the cervical area. I do not like how it looks, but so far I have little discomfort.

    Susan
    Susan, have you mentioned this to Dr. Hu? If not, I would. Where does your fusion begin at the top?
    Anyway, I don't mean to hijack this thread but thought it was worth mentioning. I'm not sure of the term since I haven't been on here for awhile, but isn't there something called proximal junction kyphosis? It's where you develop kyphosis just above your fusion. That's why I thought you should mention that to your doctor.
    I hope you are feeling well these days!
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  9. #9
    Join Date
    Sep 2003
    Location
    Northern California
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    Yes, would prefer if the thread got back on subject.

    Susan probably has proximal junctional kyphosis, which is VERY common in adults. Perhaps the discussion of that can move over to Susan's thread.
    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

  10. #10
    Join Date
    Mar 2010
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    Sorry about that. It wasn't meant to continue. I only made a comment because it was mentioned and it is another complication that can happen.
    If we focus on complications when we decide to have surgery, we would drive ourselves nuts. It's good to be informed, but not to the point of making us paranoid. I sincerely hope that Jill's fusion is solid and stable. I even find myself examining my rib humps for changes and I haven't had surgery. I think it's pretty normal for us to know our body shapes a little too well.

    Again,
    My apologies Jill.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  11. #11
    Join Date
    Jun 2011
    Location
    Southern CA
    Posts
    2,262
    Please keep us informed

    I will be praying for you

    Melissa
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  12. #12
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    Jan 2009
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    Ames, Iowa
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    Jill--I almost hesitate to say this, I may have before though. I hate bringing in a negative truth at least in my case. My rib hump was much better at first but has definitely gotten worse each year since. Not as bad as before surgery. At 5 year check-up this April I asked for the measurement for that--can't remember what they call it. 2 years before it had increased 2+ from year before. I knew it was worse again by how clothes fit and just looking at it. Dr. said he didn't want to focus on that. I was rather crushed cuz that was my main question. I guess that response pretty much answered it anyway. I actually wrote back and asked if they could give me the reading on it from x-rays because I was so upset they wouldn't give me a "score" for it. But can't do it with x-rays. Granted by the time we got in it was 6 PM and he probably didn't want to deal with it then. Otherwise he's been a very good surgeon.

    I bet this has nothing to do with the fusion. That stays. But that doesn't prevent a fused spine from rotating--almost like on its axis. My myofascial massage therapist and now physical therapist work the intercostal? muscles along my ribs. It truly can make it appear better. Maybe doesn't last long but it helps. My husband can even tell the difference. For the last 4 1/2 years he tried to say it wasn't so bad. He now admits that it is much larger.

    I actually took pictures every month for a long time of my back to see the difference. However, at 9 months that is very early and could just be from the swelling going down and then you see the true nature of backafter surgery. Settling is part of it too. Mine was pretty pathetic to start with and like you said it was exciting originally to see it so much flatter.

    Maybe this doesn't normally happen but it seems it has been somewhat overlooked by surgeons.

    It was a "have to" situation so it's still way better than if I hadn't done it 5 years ago! Janet
    Janet

    61 years old--57 for surgery

    Diagnosed in 1965 at age of 13--no brace
    Thoracic Curve: 96 degrees to 35 degrees
    Lumbar Curve: 63 degrees to 5 degrees
    Surgery with Dr. Lenke in St. Louis--March 30, 2009
    T-2 to Pelvis, and hopefully all posterior procedure.

    All was posterior along with 2 cages and 6 osteotomies.

  13. #13
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    Sep 2003
    Location
    Northern California
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    I think the return of the rib hump is actually a relatively rare thing, at least in people who got good correction originally. I can't imagine what would cause it to occur in a small subset of people. I'll ask around and see if anyone has a theory.

    --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

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