Failed Spinal Fusion (Failed Back Syndrome)
Medical Disclaimer
A spinal fusion surgery is a solid bone bridge between two areas of the spine
which at one time moved freely or independently from one another.
There are many types of spinal problems that are treated by spinal fusion.
There are different techniques for spinal fusion and sometimes hardware (instrumentation)
is used to assist in obtaining a solid fusion This includes screws, hooks,
rods, wires, and cages, usually made of Titanium. A fusion might include
wedging a piece of bone, harvested from the patient, or what is called an
Allograft implant, which is real bone, just harvested from a cadaver.
The bone is then placed between two vertebrae and over time, letting those two
vertebrae form a solid bone bridge. This takes anywhere from 3 months to over a year.
Unfortunately, obtaining a solid fusion is not always easy
and even in the best of hands a fusion may not form as intended and a
suboptimal or poor result may develop.
Common Reasons for Failed Spinal Fusion
Poor bone healing leading to a pseudarthrosis. This may be
due to the patient tissues that do not heal bone well, inadequate bone placed
into the fusion area, excessive motion across the fusion area limiting healing,
infection, and suboptimal alignment or fusion technique. Smoking leads to poor
oxygenation and may contribute.
Poor alignment of the fusion. If the spine is not aligned properly, then the
forces across the intended fusion area are such that the bone may not heal,
the adjacent areas of the spine degenerate, or fail and the muscles are strained
to maintain overall balance. This can all lead to pain and significant
disability.
Suboptimal strategy. Despite a thorough evaluation and diagnosis, the optimal
treatment for complex spinal conditions remains a challenge. Even experienced
surgeons may not achieve good results in some cases. Identifying the
source of pain can be difficult, effectively carrying out a surgical plan,
and considering the many subtle aspects involved in pain and deformity are
an tremendous challenge. Even when all goes as planned, there
may be unpredictable results.
Chronic nerve injury and irritation. Assuming a source of
pain has been clearly identified, a surgical strategy has been outlined and technically the surgery
has been a success, clinical failure may result. For reasons uncertain, chronic
pain may persist even with what appears to be surgical success (good fusion,
freed nerves) and excellent radiographic findings (clear spinal canal, good
alignment, solid bone healing). It appears that chronic nerve type pain, and
back pain with muscle spasms can persist even in the setting of what would
otherwise seem to be a technical success. In some cases this may be due to some
element of permanent injury or inflammation to nerves or a deregulation of pain
control.
Back and Spine Resources
All About Back and Neck Pain - Provides resources and information for patients, and health care professionals specializing in back pain and neck pain care. Owned and published by DePuy Spine, Inc.
AskMen.com - Article with exercises to build back muscles and to minimize the risk of back pains
The Back Page - Comprehensive information on Low Back and Neck Pain.
Back Pain - Comprehensive information and resources to help understand and treat this common disorder from about.com.
Back Pain - Neurology Channel - Information on back pain, part of the Neurology Channel Web site. Written by neurologists.
Back Pain Articles - Information about back pain and back pain treatments.
Back Pain Be Gone - Good Housekeeping Institute experts review health products that promise back pain relief.
Back Pain Information - Resource for information on back pain including symptoms, causes, treatment options, and doctor database.
Back Pain Information Page - Brief information sheet compiled by the National Institute of Neurological Disorders and Stroke.
The Back Pain Information Web - Back pain information, signs and symptoms, medications, diagnostics, treatment, living with chronic pain. Written by licensed Registered Nurse in the state of NY who suffers long term disability due to back problems.
Back Pain Management - Information on causes, treatment and prevention.
Back Pain Site - Information about conditions, therapies, exercises, and doctors who treat this disorder.
Back Problems Message Board - Bulletin board for discussion of back and spine problems.
BackCare - UK charity offering advice on how to care for your back. Some good information on self care.
Backpain-Tips.com - Tips and advice for those with back pain.
Coccyx Pain - Coccyx (tailbone) pain, or coccydynia, is often caused by a fall or childbirth. This site describes diagnosis, treatment and ways to cope.
DBC South Asia - Malaysia - Documentation Based Care offers back, neck and shoulder treatment. A non-evasive but evidence based treatment for chronic musculoskeletal problems.
eMedicine Health - Back Pain - Information on causes, symptoms, and treatment of back pain.
eMedicine Health - Sciatica - Information on the causes, symptoms, and treatment.
E-spine.com - Helping people make informed decisions about spine surgery.
Home Exercise Program - Exercise prescription for back pain.
International Spinal Injection Society - An association of physicians interested in the development, implementation and standardization of percutaneous techniques for the precision diagnosis of spinal pain. Find a member section and patient information.
Key Components in Back Injury Prevention - Article from the Medical College of Wisconsin.
A Laymans Guide to back pain solutions. - A site devoted to understanding the mechanics of back pain.
Low Back Pain - Information about causes, diagnosis, treatment and prevention.
Low Back Pain - Brief information sheet compiled by the National Institutes of Health. Includes links to other resources.
Low Back Pain - Information on retraining the transversus abdominis muscle under ultrasound.
Low back pain - Information for patients on low back pain, a common condition. Includes symptoms, causes, diagnosis, reg flags, investigations, treatment, and prevention information.
Low Back Pain Fact Sheet - Low back pain fact sheet compiled by the National Institute of Neurological Disorders and Stroke (NINDS).
Medline Plus: Back Pain - In depth overview of back pain and it's diagnosis, treatments, new developments, clinical trials, prevention, coping, rehabilitation, and research.
North American Spine Society - Non-profit medical society focused on improving spine medicine through advocacy, research and education. Includes patient information on spine disorders.
Orthospine - This New York clinic provides good quality information on a range of back problems, including, scoliosis and herniated disc.
RadiologyInfo - Myelography - A patient's guide to this x-ray procedure used to examine the spinal cord and spinal column. Learn how to prepare, what you might experience, benefits, and the risks.
RadiologyInfo: Vertebroplasty - Information for patients about vertebroplasty. Learn what you might experience, how to prepare for the procedure, and the benefits vs. risks.
Savon Health - Back pain information site.
SpinalStenosis.org - Information, resources and links for physicians and their patients dealing with Lumbar Spinal Stenosis.
Spine Dr. - Spine Dr., an informal group of patient-oriented spine surgeons across the United States. Spine Dr. provides information to people with spinal symptoms, paramedical and medical spine healthcare practitioners, and spine surgeons.
Spine Health - Information about back pain and neck pain, including causes, symptoms, diagnosis and full range of treatment options.
Spine Universe - Back pain and spinal disease portal.
Spondylolithesis - Information on the above condition from a sufferer. Includes a description of the condition and various treatments.
Vertebroplasty - A short description of vertebroplasty, a treatment for compression fractures.
Yahoo! Health - Back Pain Health Center - Information on back pain causes, symptoms, and treatment options.
See Also:
Fractures
Neurological
Disorders
Personal
Pages
Ruptured
Disk
Scoliosis
Spinal
Cord Injury
Sprains
and Strains
Health: Alternative: Chiropractic
Health:
Conditions and Diseases: Chronic Illness
Health:
Medicine: Medical Specialties: Pain Management
Health: Medicine: Surgery:
Orthopedics
