L5-S1 non union, incomplete fusion

Posted by lisajanec @lisajanec, Apr 25 10:28am

I had spinal fusion L4-S1. L5-S1 did not fuse. Is it normal to have pain and be off balance?

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I am suprised that a fusion of L5-S1 was attempted especially since L4-L5 was also fused. With both fused, there is no level remaining in the lower spine to allow or facilitate the amount of movement that the lower spine needs to make. I am speaking only from my own experience; I am not a medical professional and certainly not a spine surgeon. I am fused from L2-L5. I have significant pain from osteoarthritis at L5-S1. The brain/spine surgeon I see has said that any attempt at fusion of L5-S1 would result in a "failed fusion." He would guarantee it; therefore it was not an option to even consider. So I have been living with the pain and lots of Tylenol (not exceeding the maximum recommended dose), and considering the possibility of a spinal cord stimulator.

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hmmm spinal cord stimulator, will have to look that up.

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@lisajanec
I had decompression and fusion of L3-L5 in 2024 and many of my symptoms have improved (pain/weakness/numbness lower back, hips, buttocks, legs and feet). I have heard of many who get fused at L5-S1 and have failed fusions and pain. I have limited ability to twist and need to be careful when I do bend down to lift or reach for something. I have some L5 nerve roots exposed and being irritated and some issues with my L5-S1 joint causing radiculopathy and at times I lose control of my foot. My surgeon never suggested to fuse this level.

Have you tried cortisone injections? Do you use Salonpas lidocaine nerve pain patches for temporary relief? Does ice or heat help? I’m not sure if physical therapy would help you strengthen other parts of your body/core to better support your spine and reduce pain.

The person I know who had a failed L5-S1 fusion just recently had a spinal cord stimulator put in and he said it has helped him a lot deal with significant nerve pain.

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I do use the lidocaine patches and will review the spinal cord stimulator with my dr. Thank you for this reponse, although I don’t want anyone to have pain, it’s helps to know I’m not alone out there 😊

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I am 20 yrs old and I had my L5 and S1 "fused" July 2024, my pain has been worsening since. My hardware is intact, the left side is fused while the right isn't. Yet this isn't the source of my pain according to my doc. I am currently in pain management, I use a heating pad and heated seats, I can't work anymore even in pain management. I tried patches, injections, muscle relaxers, gabapentin, tens unit none of those helped. I am thinking about asking my doctor about a SPECT-CT (supposed to help locate pain on a specialized ct scan).

I hope that you can find some relief some type of way, back pain is the worst. I wish there was a better working treatment instead of the fusion surgeries.

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Profile picture for mpar6771 @mpar6771

I am 20 yrs old and I had my L5 and S1 "fused" July 2024, my pain has been worsening since. My hardware is intact, the left side is fused while the right isn't. Yet this isn't the source of my pain according to my doc. I am currently in pain management, I use a heating pad and heated seats, I can't work anymore even in pain management. I tried patches, injections, muscle relaxers, gabapentin, tens unit none of those helped. I am thinking about asking my doctor about a SPECT-CT (supposed to help locate pain on a specialized ct scan).

I hope that you can find some relief some type of way, back pain is the worst. I wish there was a better working treatment instead of the fusion surgeries.

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@mpar6771 Welcome to Connect. It must be frustrating to keep enduring pain. I have had a situation of nerve compression from thoracic outlet syndrome in addition to being a cervical spine surgery patient. I have done a lot of physical therapy and my PT has done a therapy called myofascial release that has helped me a lot by loosening up tight tissue. Surgery creates scar tissue and that can lead to pain when it gets tight. It does not show up on imaging. We have a discussion on Connect about MFR if you search for it where you can learn more. I do this a lot to maintain body alignment by releasing restrictive tissue and I work on the surgical scar tissue and it relieves the pain. I have also done this on my ankle with surgical scars from a fracture fix. That lets the joint function better instead of binding up from tightness. It also reduces wear and tear if the body moves properly.

Do you think this would be something to try?

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Profile picture for mpar6771 @mpar6771

I am 20 yrs old and I had my L5 and S1 "fused" July 2024, my pain has been worsening since. My hardware is intact, the left side is fused while the right isn't. Yet this isn't the source of my pain according to my doc. I am currently in pain management, I use a heating pad and heated seats, I can't work anymore even in pain management. I tried patches, injections, muscle relaxers, gabapentin, tens unit none of those helped. I am thinking about asking my doctor about a SPECT-CT (supposed to help locate pain on a specialized ct scan).

I hope that you can find some relief some type of way, back pain is the worst. I wish there was a better working treatment instead of the fusion surgeries.

Jump to this post

@mpar6771 Some doctors are fusion crazy. I had L5-S1 fused 11 years ago and still working with a pain specialist for 7 years. He has tried 10 minimally evasive procedures with no improvement. You may want to try a spinal stimulator. It helps many people. The only thing that I take is Norco. It gives my 50% of a normal life back and I live alone.

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Profile picture for mpar6771 @mpar6771

I am 20 yrs old and I had my L5 and S1 "fused" July 2024, my pain has been worsening since. My hardware is intact, the left side is fused while the right isn't. Yet this isn't the source of my pain according to my doc. I am currently in pain management, I use a heating pad and heated seats, I can't work anymore even in pain management. I tried patches, injections, muscle relaxers, gabapentin, tens unit none of those helped. I am thinking about asking my doctor about a SPECT-CT (supposed to help locate pain on a specialized ct scan).

I hope that you can find some relief some type of way, back pain is the worst. I wish there was a better working treatment instead of the fusion surgeries.

Jump to this post

@mpar6771 Hi, sorry about Ur circumstances... So has ur Doc offered any ideas what may be Causing your pain? Is it only your back or anywhere else. And wanted to know if Epidural Fibrosis was ever discussed or considered. If not might also be a possibility you want to google. It's basically scar tissue from the surgery growing around and adhering to your Lumbar nerve roots and Compressing them...Even though none of my providers suggested it, it seems to have a high incidence in failed back surgeries... best wishes going forward.

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Profile picture for linda6101 @linda6101

@mpar6771 Some doctors are fusion crazy. I had L5-S1 fused 11 years ago and still working with a pain specialist for 7 years. He has tried 10 minimally evasive procedures with no improvement. You may want to try a spinal stimulator. It helps many people. The only thing that I take is Norco. It gives my 50% of a normal life back and I live alone.

Jump to this post

@linda6101 Hi, fusion and $ crazy... Was wondering the same, have any of the minimally invasive procedures you've had been for Epidural Fibrosis? It's basically scar tissue from the surgery growing around and adhering to your Lumbar nerve roots and Compressing them...Even though none of my providers suggested it, it seems to have a high incidence in failed back surgeries... best wishes going forward.

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Profile picture for Jennifer, Volunteer Mentor @jenniferhunter

@mpar6771 Welcome to Connect. It must be frustrating to keep enduring pain. I have had a situation of nerve compression from thoracic outlet syndrome in addition to being a cervical spine surgery patient. I have done a lot of physical therapy and my PT has done a therapy called myofascial release that has helped me a lot by loosening up tight tissue. Surgery creates scar tissue and that can lead to pain when it gets tight. It does not show up on imaging. We have a discussion on Connect about MFR if you search for it where you can learn more. I do this a lot to maintain body alignment by releasing restrictive tissue and I work on the surgical scar tissue and it relieves the pain. I have also done this on my ankle with surgical scars from a fracture fix. That lets the joint function better instead of binding up from tightness. It also reduces wear and tear if the body moves properly.

Do you think this would be something to try?

Jump to this post

@jenniferhunter I have thought about this but my doctors haven't gone into any detail about it so the only research I have is what I have found on the internet. So far I have only done one day of PT in October 2024 just a couple months after the surgery. They had me do every exercise in the book and I could not move the next day, I was in worse pain than even after waking up from the surgery or the month from surgery. It has been that way ever since that appointment. I honestly went back to work and tried PT way too early it was only 2-2.5 months from the surgery before I started my daily life for about a week and then that PT appt and I haven't been back.

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