How do I know if my fusion was successfull?

[bpartin]

In August 2007 I had decompression and fusion with hardware to L5/S1, I have had bad pain since. My Ortho specialist sent me to the pain center and they have me on Methadone 10mg at bedtime and Hydrocodone 7.5 mg 3 times a day.
On the 8th month post surgery my MD wanted to discharge me and I told him I wanted to know what was causing me so much pain and he said he didn't know why, maybe he needed to have a CT scan to see what was wrong, he had sent me for a Myleogram and CT scan 2 months earlier and I told him so, at that point he looked at my file and it was on the top. He read it and told me my screews were loose and I needed to have more surgery done to take more bone from my hip and fuse it to my spine. This is what he was supposed to do in August 2007. I had wondered at the time of the surgery why my hip was not sore or anything, I know they can toke out bone from the same they make in your back to correct the spine, but my hip was never sore. I told him no and he seemed to get irritaded when I told him no I didn't think I was in shape to have another surgery like this one. He said for me to think about i fort a few months.

I asked my MD to send me to another Ortho specialist and she did. This one had me to pick up my last CT scan and he also took x rays in the office he said that he would not see a fusion and ordered a MRI with contrast to see the fusion.
I saw him today and he said he could not tell me if there ever was any fusion or not, that on the CT scan, X rays and MRI he could not see any fusion and the only way to find out was to have another surgery to check for fusion.

What I am confused about is: I have read posts form patients who have had their MD visits and thier OP told them they had fused. Why can't the doctor tell if my fusion has been a success?
How do I know if it was for wasn't successfull? How can I find out?

[rmm21]

A related discussion, additional fusions? was started.

[bpartin]

I have been to a Ortho Surgeon and took with me my CT scan done in 2/4/08 and he ordered an MRI which was taken last week. I went back to him yesterday 9/3/08 and he told me he could not tell me if I had fusion if I did not, that the only to tell if I had would be to do more surgery and look for the fusion. I an almost 65 years old and am not in the best of health didn't want to have another serious of a surgery.
I live in Jacksboro, Tennessee and my insurance is not the best paying policy and many doctors will not take it.
Thanks for you help.

[Paul J Slosar]

Dear bpartin,
The most accurate, non-surgical test to assess fusion is a CT scan of the spine with 3 dimensional reconstruction images.  Most spine centers have this capacity.  Doing a surgery exploration used to be the best way but it exposed the patient to another sugery.  With modern CT imaging, I find it to be very accurate to determine if a fusion is solid.
MRI scan does NOT assess fusion which is bone.  MRI is better to look at nerves and discs.
You need to consult with a spine surgeon with extensive experience in dealing with failed fusions and reconstructions.  There may be a way to improve your pain but it does not sound like your current team is up to the task.  If wish to post your location I can give you some suggestions.