If you have a fusion surgery, you're usually getting it to limit the movement in the impacted area of your neck or back to help restore stability to the spine and eliminate or minimize your pain levels after a damaged disc gets removed. However, it is possible for a fusion to fail after surgery. When this happens, you'll call it pseudarthrosis or a non-union. This means that your spinal fusion surgery was unsuccessful. We'll outline causes, symptoms, and treatment options available to you below.
This condition can happen in any part of your spine where a surgeon attempts a spinal fusion. The goal of this surgical procedure is to join two vertebrae as one solid piece, and the surgeon can use an anterior lumbar interbody fusion or an anterior cervical discectomy and fusion to complete the fusion process. One problem with these surgical procedures is that the graft material that they use for the fusion doesn't fully form to create solid bone tissue. If this happens, the impacted area will still have movement, and you can still experience pain.
Non-unions usually happen when you have poor bone healing after the surgeon performs the fusion procedure. A surgical oversight can be to blame, including steps they take before you have the surgery or steps during the procedure. There is also the chance of the fusion failing due to long-term habits on behalf of the patient.
For example, if you're a routine smoker, you have more chances of your spinal fusion failing to form correctly. Taking a few different steroid medications could also interfere with your body's natural healing processes after surgery. There are a few other risk factors to consider, including:
- Certain chronic conditions
- Hunter Syndrome
- Metabolic disorders
- Uncontrolled diabetes
Symptoms Your Spinal Fusion Failed
The most common symptom that your spinal fusion failed is continued pain levels in the impacted area after surgery. The pain can linger after a reasonable healing period. Your symptoms can easily spread to your shoulders, arms, legs, or lower extremities if the non-union leads to irritation of your nerves. Some patients can also experience stiffness in the area, numbness or similar sensations, and general spinal weakness. This weakness can center around the impacted area.
A lot of the symptoms you can experience with pseudarthrosis mimic what you'd feel if you had osteoarthritis. Other common symptoms include persistent pain, lack of mobility, joint clicking, fever, and redness.
Factors that Increase Your Risk of Pseudarthrosis
Your surgeon's ability doesn't necessarily impact the results of your surgery. There is risk associated with this surgery, just like there is with any surgical procedure. Since there is no guarantee of a 100% success rate, there are things you can do to improve your odds. You want to pay attention to any recommendations the surgeon gives you before the surgery. Make a point to stick to a healthy diet and incorporate exercise into your daily routine during recovery. Since medical technology advanced, you have better chances than ever of having a successful spinal fusion surgery. Other risk factors include:
- Health Status - Things like poor nutrition, old age, smoking, alcohol consumption, and hyperparathyroidism all contribute to having a higher risk of a non-union. They work to slow down your body's natural healing process.
- Infection - It's possible for this condition to develop if you get an infection in the surgical site. If you damage the surrounding muscles, have a loss of blood supply, or have bone loss, this impacts your healing process. Interruption of the blood supply can mean you develop avascular necrosis. This is the death of tissue and bone, and it can lead to immobility and pain.
- Non-Compliance - Not getting enough rest after the procedure and not wearing any braces or devices your surgeon recommends after surgery can cause this condition to develop.
If the cause of this condition is directly related to the fracture, you can prevent it by treating the wound well. This can help prevent infection. If necessary, it could resort to surgery before the condition gets more complicated to remedy.
Treatment for Pseudarthrosis
If your symptoms are very mild or nonexistent, your surgeon may suggest that you don't need any further treatment. Some patients with this condition do respond very well to physical therapy, medication, and other non-surgical intervention techniques for pain management. However, this is rarer with a non-union.
A lot of the time, you may need revision surgery as your treatment option to get relief. Before this happens, the surgeon may request x-rays to help rule out the causes of your post-surgery symptoms. In some cases, you might not notice any disruptive symptoms until several months or even years after the initial surgery. This can add a layer of complexity to the diagnosis process. If you need a second fusion, the surgeon could:
- Pick a different material for your bone graft
- Perform a different approach to the fusion surgery than you originally had
- Correct your existing hardware from your first surgery
There are a few surgical treatment options available to help with this condition, including:
- Bone Grafting - The surgeon will take bone grafts from a donor or from the patient to help stimulate the healing process in the damaged bone.
- Electrical Stimulation - Ultrasound or electromagnetic waves work to encourage the formation of bone cells. The cells will then form the hydroxyapatite structure to prevent breakage or bending.
- Fixation - Metal rods, bolts, screws, and plates can get placed inside or screwed into the fractured bone to help stabilize the fragments.
Contact Florida Spine Associates to Learn More About Pseudarthrosis
If you'd like to know more about this condition, your risk factors, and whether or not you have this condition, contact us. Our staff is ready to set up a consultation and discuss your concerns or questions today.