@jraffuel Hello and welcome! I can understand your disappointment with a setback during your recovery. Of course, it's hard not to be upset by that. I would feel the same way.

Have your doctors investigated why the compression fracture happened beyond saying the hardware caused it? Is there a cage that would be a better choice for this?

Compression fractures are somewhat common in older patients with osteoporosis who have less bone density. It happened to my mom at age 92 and because of severe osteoporosis, she was not a candidate for the procedure that glues the bone back together with bone cement. She had a brace to wear instead, and it healed with a 43 degree curve adding some deformity to her spine.

The lumbar end of the spine is bearing most of your body weight, and pedicle screws must be placed at precise angles so they do not pull out and be the right size for the patient. If the surgeon places rods into the spine, this is how they anchor the hardware.

I am a spine surgery patient with a cervical fusion that was done with only a bone disc spacer (no hardware or metal plate). My surgeon told me that it heals best with bone spacers because it is natural. I don't know if they use those at the lower end of the spine because of the body weight pressure. The spacer is the mineral matrix left after all bone cells are cleaned out of it from the donor. During healing new bone building cells move in and colonize the matrix, and some of it is reabsorbed and the news cells build more bone.

The concern now would be to prevent a spine deformity that would affect your spine alignment from here on as you recover from the surgery. If your bone mineral density is less than it should be, an endocrinologist would be a good consult. It is common for lumbar surgeries to have a front and back approach. It all depends where they need to stabilize the spine. Have they discussed what new hardware should be used now, and why this is better? What will prevent another hardware failure? Certainly a discussion about how experienced the surgeon is with this more complex surgery would be helpful. I have watched a lot of spine presentations by surgeons online and they say that L5 S1 is the most difficult level to fuse because of the pressure. I don't know if your surgery would extend toward also fusing to S1, but it raises questions in my mind.

Do you have revision surgery scheduled or are you seeking another opinion beyond what you have now?