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Back Problems Message Board

Back Problems Board Index

Greetings Everyone!!!
I apologize from the beginning since I know this will be lengthy. But I want to give as much info as possible to get appropriate suggestions from others. I live in Austin, TX and my surgeon (one of best in State) is in Houston = 200 miles.

12/22/05 - Had L4/L5 anterior fusion, no cage, femoral strut allograft (donor bone) & demineralized bone chips w/ Synthes anterior lumbar plate + two screws used. Also performed posterior, Bilateral L4/L5 hemilaminotomies + bilaterial gutter dissection, bilaterial nerve root foraminotomies.

Approx 1 month post op, donor bone caused a compression fracture and collapsed into vertebrae below. Occurred days after previous followup w/ surgeon in Houston so it went untreated for another month. By that time, little could be done but to hope it fused as it was.

All symptoms continued to exist w/ some lessened shooting pain. Incredible lumbar pain into buttocks/hips remained.

MRI on 7/18/06 - At L3/L4 mild to moderate disc degeneration. Slight retrolisthesis of L3 on L4. 2 mm broad-based disc buldge. Mild central canal stenosis. Moderate bilateral facet anthropathy. Mild bilateral foraminal stenosis. At L4/L5 thecal sac is decompressed via posterior central laminectomy. Moderate right and left lateral enhancing epidural fibrosis w/ right & left lateral enhancing epidural fibrosis. Moderate bilateral foraminal stenosis. Mild to moderate facet arthropathy. At L5/S1, no disc bulge/herniation. No central canal stenosis. Mild facet arthropathy & mild bilateral foraminal stenosis.

CAT scan on 7/18/06 - At L3/L4 slight retrolisthesis of L3 on L4. Mild central canal stenosis, mild foraminal stenosis. At L4/L5 thecal sac decompressed via posterior central laminectomy. Interbody bone plug (donor bone) shows no definite CT evidence of incorporation into the superior endplate of L5 and no definite healing at this point. There are anterior cortical screws w/ anterior interconnecting plate. Mild foraminal stenosis. At L5/S1 no disc bulge/herniation. No central canal or foraminal stenosis.

Essentially, w/in one year, L3/L4 has died. It was fine on films a year ago. Also, and MOST IMPORTANT, the donor bone that was supposed to fuse to L4/L5 is not even touching L4 and only touching L5 in a 2 mm spot. Essentially, this donor bone is floating around and the only thing preventing L4/L5 from collapsing onto the donor bone are the screws and plate which, obviously, were not designed for this and WILL fail.

Surgeon is now recommending a posterior, dual-level fusion. I think I have no choice at L4/L5 level. Any suggestions? How will he "fix" the failed fusion? Will they remove the donor bone and start over? Should a cage be recommended? Any other techniques to look at that might prevent this from occurring again? I'm desperate for help and answers but there might not be any. If you have ANY suggestions, or answers, PLEASE RESPOND!!!


Open ACL reconstruction, left knee, Feb. 1994.
Right knee, torn meniscus. July 1995
Both shoulders - subacromial decompression. April 1997/Aug. 1999
Open Subcutaneous Ulnar nerve transposition, medial epicondylectomy. June 2001
Carpal runnel release (dominant/right hand/elbow), June 2001.
Torn Labrum, right hip scope, Dec. 2003.
Anterior Lumbar fusion, Dec. 2005.

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