What Happens When Spinal Fusion Disintegrates?
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The Process
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Spinal fusion surgery attempts to correct damage to the spine caused by bone injuries, poor alignment or degeneration of the spongy disks that separate the vertebrae (the bones that form the spinal column). A successful procedure removes damaged bone or disks, fills the area in with new bone and implants a metal plate to stabilize the area until the bones fuse together. Occasionally, however, the patient suffers Failed Back Surgery Syndrome (FBSS) due to a fusion problem, hardware breakage or transfer of the degeneration to a different disk.
Failure to Fuse
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A spinal fusion may take anywhere from three months to a year to become completely solid. During this recovery period, doctors find it hard to tell how well the bones are fusing or whether they will fuse completely, and they will usually refuse to consider a second operation. Even if the fusion fails, the implant may keep the spine stable enough to relieve back pain without additional surgery.
Bone fails to fuse in up to 40 percent of fusion surgeries. Smokers have a higher rate of fusion failure than non-smokers. If the patient continues to have pain, the doctor may recommend a second surgery, usually more extensive than the first.
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Implant Failure
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While the metal implant can usually support the spine during the recovery process, it may not be able to do so permanently. The longer the spinal bones take to fuse, the more stress the metal implant must take over time. The metal implant is secured to the bones by screws, but over time these metal pieces can grow weaker until they finally break. Larger implants over several bones face a higher risk of fatigue and failure.
Transfer Lesion
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Even when fusion surgery relieves pain and degeneration in one area of the spine, it may cause new problems in another. In a transfer lesion, the support and stiffening of the implant site can transfer additional stress to neighboring disks and vertebrae, causing pain. Transfer lesions seems to occur more frequently in young adults than older ones, though patients who suffer from arthritis can also get them. If the transfer lesion causes serious pain, nerve compression or disk degeneration, the patient may have to undergo another fusion surgery to correct the new problem.
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