Failed Lumbar Fusion

Xray of screws in spine

Spinal fusion is typically performed on those with degenerative disc disease (DDD), or those that struggle with back pain caused by spinal stenosis, disc herniation, spinal fractures, kyphosis, scoliosis, and several other common issues of the spine.

Lumbar fusion, specifically, is performed on the majority of those that undergo spinal fusion. Over 200,000 patients every year seek out lumbar fusion to treat their chronic back pain. But, despite its success as a procedure, a large percentage of those that undergo this type of surgery still experience pain. In some cases, the pain is as severe as it was before surgery.

Why Do Some Lumbar Fusion Surgeries Fail?

The term for this is failed back surgery syndrome, or FBSS, and It is an uncommon – but not rare – issue that occurs with many types of back surgery. Those that experience failed lumbar fusion surgery often experience a recurrence of the same pain that they experienced prior to surgery. But they may also experience new pain, or cause pain to come back in the future.

Although there are different ways to perform lumbar fusion, they all follow a similar process:

  • An incision is made to get access to the spine.
  • A bone graft is added to the bones so that they fuse together.
  • Hardware is considered and added so that the bones move together.

This process opens up many possible causes of failed lumbar fusion, including, but not limited to:

  • Failed Bone Graft – Bone grafting is designed to trigger a natural process that fuses the bone together. If the bone graft fails, the fusion cannot take place, and the pain will return.
  • Posterior Spinal Fusion – 80% of all lumbar fusion procedures are posterior, which means the surgeon comes in through the back where it’s easier. But anterior spinal fusion (with an incision through the abdomen) has better success rate, with fewer hardware errors. It’s possible that your surgeon used a posterior incision when it was not appropriate for your body.
  • Misdiagnosis – In many cases, FBSS in lumbar fusion is the result of misdiagnosis. Your surgeon may not have correctly identified where the pain occurred, or how to best address it.
  • Surrounding Disc Problems – When you change the way your spine works, it can create other challenges, especially if not completed correctly. The lumbar fusion may have been successful, but it may have caused the other discs to move in a way that further damages them.
  • Loose or Broken Hardware – From the pedicle screws to the installed hardware, there are many possible ways to introduce new challenges.

Lumbar fusion can be a successful surgery. But there are also significant differences in the quality of surgeons, both in terms of their decision making and in their ability to perform a successful surgery. All of these may introduce problems as well.

How to Treat Failed Lumbar Fusion

For those that have experienced FBSS, there are several treatments. Follow up revision surgery, if necessary, can be a useful tool for solving the cause of the chronic pain. In some cases, non-surgical intervention may be possible as well. But an accurate diagnosis is key. For more information about failed lumbar fusion, call Spine Center Atlanta today at 404-351-5812.

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