Failed lumbar fusion

I was at UPMC for four brain stem surgeries and at UPMC Shadyside for my mitral valve repair

@bgl I join Rachel in welcoming you to Connect. It sounds like you have a tough road ahead of you and that once you get past this correction, your real recovery can begin.

What helped me a lot before and after my cervical spine surgery is a physical therapist who also does myofascial release which can help break up surgical scar tissue. You can have adhesions in the fascial layers that connect the skin incision scar to the internal surgical site and as that scar tissue forms, it tightens up and can increase pain. For me that started happening a couple months after the surgery, but at that time, my PT wouldn't touch anything until the fusion began to fuse, so I had to live with it until then. When I could get things stretched out again, it really helped.

Here is our discussion about myofascial release in case you are interested in learning about the benefits of this therapy.

- Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/

Do you have issues with bone quality that could have contributed to the failed first surgery? I know that when screws are placed, they also need to be at very precise angles. When surgeons do this in the lumbar spine, or at the lumbar sacral junction, screws attached to the rods can pull out if not at the correct angles because of all the forces exerted at the lower end on the spine. Have your doctors given you some assurance that this won't happen again?

I don't know anyone with a similar experience, but I have heard of a patient having fractures in the spinous processes right after a cervical fusion surgery. I hope your surgery will help get you back to a positive outcome, but I'm sure that will be a long recovery.

Dear Jennifer,
Thanks for getting back to me. I was told the reason the fusion failed was because the pedicles of the bones are really small and they should have used a pediatric screw instead of a regular screw and the angle on my lower back is 90 degrees and that added tension to the fusion. I did have a lot of scar tissue from the previous surgery as well. When I went back to see the surgeon after he said the operation was horrendous and I was in a lot of pain. He referred me to another Dr. after he saw the x rays and told me I was going to need a redo and said he probably never should have operated on me and that he thought he could do the conservative surgery and make it work but it didn't and now I have to do this. It was the second Dr. who told me I had the broken vertebra and the screws were coming loose
I really appreciated having someone to talk with I have not found anyone else who even knows about this kind of operation.

@bgl1 My mom has an extensive history of surgeries, some not so successful, some quite successful. I sent this to her as a reminder of her strength. I'll share it with you...

thank you !

@bgl I know about this kind of problem because of watching online videos of surgeons speaking at spine conferences making presentations to other surgeons. It was video I found because I was searching for videos for a particular surgeon and this was something he spoke about and talked about doing revision surgeries for a failed back surgery. They have to calculate everything, and if they are also correcting a deformity, they have to figure out exactly what to do if they are reshaping bone for a better alignment and building constructs with rods. They consider what they call sagital balance so the center of gravity is where it should be so as not to stress the spine further and fatigue the patient. I hope your new surgeon has a lot of spine deformity experience in major back surgeries. Have they explained how they will address this without causing further damage when applying fixation to the spine? Did they explain how they will attach implants on the front of the spine?

I am glad they were honest with you even though that must have been difficult news to hear. No surgeon wants to fail, and admitting that was probably uncomfortable for them and must have been a learning experience. They may talk about your case at conferences in the future. That probably isn't much comfort since you are the one left with the problem and a much longer recovery time to what your new normal will be. Did they show you the x-rays?

My cervical surgery was fairly simple. It was just one level, and I opted for no hardware, so all I have is a bone graft for my fusion and then I was in a neck brace for 3 months. I had some unusual symptoms, and 5 surgeons passed on my case because they didn't understand it. That was when I came to Mayo where my symptoms were understood as being related to the physical problem in my spine and the compressed spinal cord. It's hard being a patient who can't find help, and having a failed surgery would be hard too. This is the reason to ask how many procedures a surgeon has done and their personal success rate with it for what they are recommending. It sounds like this first surgeon was not very experienced in what you needed.

Rachel makes a good point to gather your strength now and healing energy and go forward believing that you can overcome this setback. I really believe that patients have some control over their outcomes in that way in the recovery that comes after the surgeon finishes his job. I had to find that myself as a way to overcome my fear of surgery and that was an important life lesson for me.

I too was a nurse who injured his back at home falling down stairs during a small earthquake in Los Angeles County, Ca high dessert community. Had my SS bars fusing L4-S1 done in 1988 and still holding firm. My L4 looks terrible but at 70 I’m not about to have more surgery. I walk 2 miles daily and exercise 2x day and know my limitations. If your pain is such that it decreases your enjoyment of life I’d consider it. Methods noes are much improved from 1988 and I see more successes that failures.

I am suffering from failed lumbar fusion surgery done by a Neurosurgeon. How can I get another Neurosurgeon to take a look at my surgery to see if their is anything that can be done for the S1 joint and the peripheral neuropathy in the legs and feet that just developed after my last hip replacement. I had this surgery 9 months ago and thought I would be able to give up my wheelchair and walkers. I am trying to find a reputable neurosurgeon get involved for a second opinion.
Thanks,
Steve Bigelow