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Thread: Failed fusion

  1. #1
    Join Date
    Jun 2005
    Location
    Bloomfield Hills, Michigan
    Posts
    285

    Failed fusion

    I posted on another thread that I am having all the symptoms of a failed fusion for the second time. I went for a myelogram and catscan the other day, but until I find out exactly what's going on I have a question.
    I don't recall if this has been covered before, but - if it turns out I'm not fusing, what's the real reason for a failed fusion and are there alternatives other than another surgery to "pack it in" again and hope it works.

    All my bone density tests categorize me as "excellent." I take a mutivitamin, vitamin E, and 1800 mg of calcium and 600 IU of Vitamin D daily. Other than my back and carrying too many pounds which I endlessly try to lose, I am in good health.

    Any ideas or any research references you know about? Thanks.
    FeliciaFeliciaFelicia
    10/24/00 posterior fusion T4-L4 at age 57
    8/5/05 posterior surgery for spinal stenosis at L4-L5; laminectomy and fusion
    5/14/07 posterior revision with fusion to sacrum
    2/11/08 anterior discectomy L5-S1, and reinforcement of fusion with plate attached to L5-S1
    3/9/2011 and 3/11/2011 revision surgery with Dr. Lenke, St. Louis - complete revision and fusion with instrumentation from T1 to sacrum, one lumbar osteotomy.

  2. #2
    Join Date
    Nov 2007
    Location
    Big Bear, CA
    Posts
    290
    Are they using your own bone for the fusion or are they using donated bone? If it's donated your body may be rejecting the donated bone as a foreign body. Sorry I can't be more help.
    Geish
    47 years old, dx at 13
    +30* to the right, +60* to the left, +30* to the right
    Surgery 12-13-07 - fusion from T4 to sacrum.


    http://www.scoliosis.org/forum/attac...tachmentid=267 Pre surgery
    http://www.scoliosis.org/forum/attac...tachmentid=268 Post surgery
    http://i156.photobucket.com/albums/t...s/DSC01091.jpg Xray from the side
    http://i156.photobucket.com/albums/t...1089-1-1-1.jpg Xray from the back

  3. #3
    Join Date
    Jun 2006
    Posts
    131
    Quote Originally Posted by Geish
    Are they using your own bone for the fusion or are they using donated bone? If it's donated your body may be rejecting the donated bone as a foreign body. Sorry I can't be more help.
    Rejecting donated bone would have shown up way before now.
    trulyaries- I won't ask you this question, I will say however I went a long time not getting any fusion and it was caused from smoking. Ended up grafting bone from my hip, stopped smoking and it all worked out great.
    BT
    March 23, 2006 Anterior/posterior Ileum-T2
    15 1/2 Hours
    Dr. Tom Lowe R.I.P.

  4. #4
    Join Date
    Mar 2007
    Location
    Melbourne, Australia
    Posts
    93
    I had fusion using my own bone but it was from my rib cage not my hip and it's all going well for me.
    2002 - 42 degree curve (top) and 38 degree curve (bottom)

    2003 - 43 degree curve (top) and 37 degree curve (bottom)

    2007 - 46 degree curve (top) and 48 degree curve (bottom)

    Anterior/Posterior surgery 17th of July and 31st of July 2007 and 2.5 cm's taller

  5. #5
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    Quote Originally Posted by BackTalk
    ... I will say however I went a long time not getting any fusion and it was caused from smoking.
    Interesting you brought this up, BT. Yet another reason I put off surgery (aside from what was proposed 10 years ago was just far more invasive that I was prepared to accept at that point) was I DID smoke.

    I haven't had a cig since Sept 25, 2006 .

    However, I just recently found out any type of nicotine replacement therapy (patches, lozenges, gum) has the same hinderance on fusion. Thank goodness I'm weaned down to about one 4mg lozenge a day - and can easily give it up.

    I AM glad I read (I believe it was in Wolpert's book) even OTC nicotine replacement also affects fusion ... and, trulyaries, I hope your issue (whatever the cause may be) is identified and remedied soon. Bless your heart for enduring all that and having such a difficult time *healing*!

    Regards,
    Pam (who is SO absolutely full of turkey and dressing it ain't EVEN funny ... *~groan~* ...)
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op 53, Post-op < 20
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  6. #6
    Join Date
    Jun 2005
    Location
    Bloomfield Hills, Michigan
    Posts
    285
    For my most recent surgery, it was a mixture - bone was taken from my hip but it was combined with donor bone. No offense taken; I was a smoker many years ago but had quit long before my first surgery in 2000, except for occasionally "bumming" a cigarette when having a cocktail or two with friends. I stayed away even from that once I knew I would be having surgeries. Interestingly, my 2000 surgery was the long fusion - T4 to L4 - and that fused just fine. But the last two lumbar fusions just don't seem to be able to get it together.
    FeliciaFeliciaFelicia
    10/24/00 posterior fusion T4-L4 at age 57
    8/5/05 posterior surgery for spinal stenosis at L4-L5; laminectomy and fusion
    5/14/07 posterior revision with fusion to sacrum
    2/11/08 anterior discectomy L5-S1, and reinforcement of fusion with plate attached to L5-S1
    3/9/2011 and 3/11/2011 revision surgery with Dr. Lenke, St. Louis - complete revision and fusion with instrumentation from T1 to sacrum, one lumbar osteotomy.

  7. #7
    Join Date
    Sep 2003
    Location
    NJ
    Posts
    1,291

    Lightbulb

    I suggest visiting a metabolic bone specialist. I did that a couple of years ago and was told my blood levels of Vit D were too low but you must be evaluated properly to find any other cause.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  8. #8
    Join Date
    Jun 2005
    Location
    Bloomfield Hills, Michigan
    Posts
    285
    Thanks, Karen. That's certainly something for me to look into. Question: were you evaluated regarding the Vit D deficiency before or after your surgery? And are you aware of any articles/research discussing this subject? I just like to do my homework!
    FeliciaFeliciaFelicia
    10/24/00 posterior fusion T4-L4 at age 57
    8/5/05 posterior surgery for spinal stenosis at L4-L5; laminectomy and fusion
    5/14/07 posterior revision with fusion to sacrum
    2/11/08 anterior discectomy L5-S1, and reinforcement of fusion with plate attached to L5-S1
    3/9/2011 and 3/11/2011 revision surgery with Dr. Lenke, St. Louis - complete revision and fusion with instrumentation from T1 to sacrum, one lumbar osteotomy.

  9. #9
    Join Date
    May 2006
    Location
    Near Houston, TX
    Posts
    495
    Have you looked into the use of BMP? It would require another surgery, but the BMP is said to almost guarantee the fusion to take place. Dr. Lenke used it on my daughter. I'm sure you can find a surgeon in your area who uses it too.

  10. #10
    Join Date
    Sep 2003
    Location
    NJ
    Posts
    1,291
    I only had the bone density study pre-op which showed "mild osteopenia"--considered normal because I was 60 at the time. I decided on my own, 3 years post-op to have a metabolic bone specialist monitor my bone density because I read, in the scoliosis literature, that bone density was important to secure the hardware. I was shocked to learn I was Vit D deficient based on 24 hour urine specimen and blood tests. I very faithfully took my calcium and had Vit D in my multivitamins. I was prescribed 1800units for several months with monitoring. Now we read about the importance of Vit D all over the place with the US recommendations changing from 400 units to 600-800u.

    Here are 3 compilations (meta-analyses) of Vit D studies:

    http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum


    http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

    http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  11. #11
    Join Date
    Jun 2005
    Location
    Bloomfield Hills, Michigan
    Posts
    285
    Thanks, Karen, for the references. I'll read up on it.
    FeliciaFeliciaFelicia
    10/24/00 posterior fusion T4-L4 at age 57
    8/5/05 posterior surgery for spinal stenosis at L4-L5; laminectomy and fusion
    5/14/07 posterior revision with fusion to sacrum
    2/11/08 anterior discectomy L5-S1, and reinforcement of fusion with plate attached to L5-S1
    3/9/2011 and 3/11/2011 revision surgery with Dr. Lenke, St. Louis - complete revision and fusion with instrumentation from T1 to sacrum, one lumbar osteotomy.

  12. #12
    Join Date
    Jun 2005
    Location
    Staten Island New York
    Posts
    298
    For the BMP - Be sure to find a skilled surgeon that has experience with BMP, If I am not mistaken, an ingredient in BMP can turn whatever it touches solid, example body tissue or organs.

    Sue

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