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Dr. Mark
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience:  U.S. Physician/Surgeon in Neurosurgery
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L3-L4 and L5..hip..With each fusion, the bone does not grow back

Customer Question

I have had 4 fusions at L3-L4 and L5.since 2002 I also have had to have a total hip replacement on the right side. I have been diagnosed with necrosis. With each fusion, the bone does not grow back. Is this due to the necrosis? I also had spinal stenosis this last surgery and had gotten to the point that I could no longer walk due to the severity of the sciatic pain in both legs. That has improved since surgery on 1-26-09 but what are the chances of it recurring?
Submitted: 8 years ago.
Category: Health
Expert:  physician123 replied 8 years ago.
Hello ,

Welcome to just answer.

As the surgery has corrected the compression of the nerve roots by the fusion at the levels of L3-L4 and L4-L5 the pain occuring as a result of the compression of the nerves at this level is minimal.

The total hip replacement which has been done can last from 15 to 20 years depending on the implant used.
I hope this answers your question .

If you have further doubts then please do let me know.

Please click on the green accept button if this answers your question as I will only be credited for my work once you do so.

Thank you

Customer: replied 8 years ago.
I still am searching to determine if the necrosis can be causing the bone to not grow back around L3-L4 and L4 and L5. I have been told that the pain may never ease up and the spinal stenosis may only get worse since I have started to have sciatica pain down one leg again. What is the % of stenosis in the same area returning?
Expert:  physician123 replied 8 years ago.

I will opt out at this stage .

One of the other experts will probably be able to help you.

Thank you.
Expert:  Dr. Mark replied 8 years ago.
First, the necrosis in the hip is entirely unrelated to the bone formation in your back. These are two separate processes.

We know that in bony fusion of the spine, that some people will fuse without a problem; others will not fuse at all. Smoking is a known risk factor for non-fusion, as it inhibits bone growth. But it is not related to necrosis.

In terms of the stenosis returning, it really depends on the kind of surgery that you have had. If you have had a full decompression (laminectomy) with your fusions, the chances of stenosis returning are far less than if you just had a fusion surgery. But there will always be a chance of it returning, due to further degeneration of the discs in your back, or scar tissue, or bone growth. It's just impossible to predict.

But if you had relief after the surgery, and have had recent return of the pain, you should have that investigated by your surgeon, as it may represent scar tissue from the surgery putting pressure on the nerves.
Dr. Mark, Doctor (MD)
Category: Health
Satisfied Customers: 11946
Experience: U.S. Physician/Surgeon in Neurosurgery
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