Hardware Removal or Fusion "fix" recommended: Info?
I had a spinal fusion, L4, L5 & S1 in August of 2012, by a Dr in MD that I completely trust and am very comfortable with. He did both of my Dad's back surgeries, and they both went well. I ended up moving to TX for treatment of another (completely unrelated) medical issue, and because it was pretty urgent, I moved about 3 months after my surgery and couldn't make the follow-up appointment. Unfortunately, the other medical condition includes a lot of memory loss, and I was pretty incoherent after some of the treatments. I wasn't in a lot of pain at the time, and I was so caught up in this other treatment that I didn't think to keep up with my back issues. I wish I had.
The pain has returned, not as severe and debilitating as before the fusion last year, but it's bad enough that I found a spinal orthopedist down here and made an appt. He took an X-ray right away (which showed bone growth), and when he looked at it, he said that there were two possible causes for the pain: either the fusion didn't take, since he couldn't tell if the growth was in the proper place from just an X-ray, or the hardware is causing the pain.
The fusion was done because of ruptured discs, and at the time, I had an additional bulging disc that was not included in the fusion, L3/L4. I mentioned that to him and he said that wouldn't be the cause, though I was so shocked to find out I needed surgery that I didn't think to ask why. I literally walked into that office expecting to be sent back to PT, but walked out overwhelmed by the idea of having another surgery.
This dr ordered an EMG, which the Dr performing the test said unofficially that it showed nerve compression. He also ordered a CT Myelogram, which he said would show if the bone growth is in the right spot, and a hardware block. I tried to ask him more about what either procedure would entail, and he responded that he didn't want to have a discussion that might not be necessary, which I understand, but most certainly don't like. One of the explanations will be necessary, and my anxiety is going crazy with the uncertainty and personal lack of knowledge when it comes to either procedure.
I'm thinking that the hardware is the issue, because my pain is pretty mild (in comparison to what I was used to before the surgery) except when the weather changes, and I was told that that's indicative of the pain being due to the hardware. Is this true?
If the hardware needs to be removed, does the bone growth also need to be removed in order to get to the hardware? I've read that if it's been less than 2 years it's unlikely, but I'd like other opinions.
What does a fusion repair entail? I'm guessing that the existing bone growth would need to be removed, since it would have grown in the wrong area, but other than that, is it the same as what the initial fusion would have been?
Any tips on questions I should be asking when I follow-up after the CT myelogram and the hardware block? I'm going crazy with all of this uncertainty, and I don't want to leave my next appt with the same feeling.
Note: I'm planning on going back to MD for the surgery so I can have the original neurosurgeon do the procedure. I prefer a neurosurgeon to a spinal orthopedist.