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Spinal Cord Disorders Message Board


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ACDF not fusing
May 3, 2007
Hello, I was disappointed to hear today that my 6 month series of x-rays (actually done closer to 7 months) show no fusion. I had ACDF with donor bone and plating last July. The plate and screws still look to be in normal position. This series of x-rays was actually ordered by my rheumatologist (I also have lupus) and she's now sending all the xrays and radiology reports back to the neurosurgeon, so I guess I will have to make an appointment with him soon.

Has anyone had an ACDF where the fusion failed? What was the outcome? The NS had dismissed me after my initial post-op, saying to just go back to activies as I felt like it, but the rheumatologist wanted me to wait to go back to high-impact activities until after we knew there was a fusion. Except it appears now there is no fusion at all. Is this unusual? It really didn't seem to be on anyone's radar that it would not fuse. The radiology report said no sign of bone growth.

I am generally doing quite well, have regained use of my hand and have much more arm strength. I do still have pain in the area where it was (supposed to be) fused. I have a high pain threshold but still occasionally take ultram -- maybe once/wk it gets to where I can't function.

Would love any stories about similar situations -- I am at a bit of a loss!
[QUOTE=neckpatient;2962267]There are people that have trouble fusing. If you smoke stop, if you take ibuprofen or other nsaids discuss this with your drs., there are some studies that indicate these inhibit fusion. They can try bone growth stimulator unit on you, there are a couple people here that had success with them. I am suprised that you don't have several fups with your neurosurgeon like at 3,6, 12 months. That seems unusual that you are not having regular xrays by the person that did your surgery.[/QUOTE]

I was wondering about that. The NS said it was a very basic surgery, and that he does tons of ACDF every month, and with the hardware there was no need for followup. I've never smoked and don't take nsaids, but because of the lupus I take some heavy-duty immunosuppressants and chemo drugs and I'm always on some level of prednisone (hasn't been higher than 10 mg/day since the surgery) but of course the NS knew that and the rheumatologist coordinated with him for a plan to prevent a flare from the surgical stress. Because of the lupus I wasn't a good candidate for autograft -- high risk of bone death at the harvesting site.

If there is no fusion but the plate is still there, do I just go about life normally, or is there additional risk that the plate will give out? I'm 37 and have kids -- I usually ride horses (but haven't since all this started -- was planning to start back as soon as I got the fusion xrays!) and I spend lots of hours each day driving and doing sports with the kids and carrying things. I know that I have a high pain tolerance, so I think it is possible I'd not realize I'm overdoing (I was jumping a horse while I had a fractured ankle; didn't realize the ankle was fractured until it wasn't supporting me!)

I know, I need to talk with the NS and I will -- but I'm not sure I was given the full story the first time, so now I'm trying to do more research so I know what to ask about. Thanks for the replies!
[QUOTE=laranol;2961338]
I am generally doing quite well, have regained use of my hand and have much more arm strength. I do still have pain in the area where it was (supposed to be) fused. I have a high pain threshold but still occasionally take ultram -- maybe once/wk it gets to where I can't function. [/QUOTE]

I wonder if you took the ultram normally after your surgery? Because I questioned my dismissal orders from the hospital, when I finally reached my NS & told him that I was taking ultram for the pain along with the percacet, he was quite alarmed & told me to stop taking the ultram because it was a blood clotter and fusion prohibitor. Perhaps this has something to do with your sad problem and you can ask your doctor. I feel for you, I'd hate to go through this again. :-(

Ro





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