The Lowdown on Low Back Pain
(and Other Aches)


I had a lumbar fusion, but I still have pain. What should I do?

Some residual pain is normal after a lumbar fusion. If you have a lot of pain, however, you need to be re-evaluated. Most pain can be treated effectively.

Leg pain, or sciatica, which occurs after a fusion, usually indicates a nerve problem. A nerve may be pinched by a remaining disc herniation or a misplaced screw. Plain X-rays and an MRI are used to diagnose this in most cases. Occasionally, an EMG or a myelogram will be needed. Nerve pain after fusion can be treated with medications, injections, therapy or tens units. At times, it is necessary to revise the fusion to remove the bone or disc which is still pinching a nerve.

The most common causes of low-back pain after fusion are "non-union" and adjacent disc deterioration. A "non-union" is a failure of the bones to properly knit or heal together. Adjacent disc problems refer to disease above or below the fusion. The pain can be treated with medications, therapy, massage, or chiropractic. X-rays taken when bending and extending will sometimes show whether a fusion is solid or if adjacent levels have gone bad. Sometimes a discogram is required. Occasionally it may be necessary to do surgery to inspect a fusion which has failed. If a fusion has failed to heal, it can be fixed as part of the inspection surgery.

If one has continued problems after fusion surgery, it is necessary to determine their cause. Additional surgery is not always needed, and there are many conservative treatments that can be helpful



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Last modified: 07/27/08