Spine fusion malpractice?

What is the name of your state?What is the name of your state? NV

I had a spine fusion surgery 2 years ago to stabilize a grade 2 spondylolisthesis at L5-S1. The doctor that performed it was an orthopedic surgeon who specialized in the spine. For the first year after the surgery, I seemed to be doing o.k. and on six different post op visits, the surgeon said that everything looked really good and that the hardware was in good position. After about 18 months, I began to have electrical jolts down my leg that felt like I was being electocuted and really unbearable pain all the way to my foot. I went back to my doctor, and he said that the hardware was still in good shape, and couldn't figure out what the problem was. He referred me to a neurosurgeon.

When I went to the neurosurgeon, he said that the screws in the L5 vertebrae were placed too high, that they were "violating" the L4-5 disc space, and that they had been there since surgery. I now had a new acute spondylolisthesis (slip) at L4-5. He pointed this out in the xrays and even in the original post-op report he showed me where it said "The L5 screws were noted to protract slightly in the area that appeared to be in the disc space at L4-5, but the screws were short and well within the pedicles and were not into the neural foramen or into the disc space."

I had surgery to remove the hardware, and the neurosurgeon said that it took him quite a while to clean up the damage. Now I have to have another fusion surgery performed to stabilize the new slip. The L4-5 disc is in last stages of degenerative disc disease. I still have pain down my leg that never lets up. I believe that the original surgeon messed up the surgery and lied to me for a whole year. Would the actions of the original surgeon be considered malpractice? Would the dishonesty be considered more aggregious than the surgical error? Thank you for any advice you can offer.

Consult with a ned/mal attorney, to nswer your questions.
You would have to have all your medical records and images evaluated by an expert. Please consider the following:
You had 18 months without a problem, so the problem with the screws was not the result of the surgery but of DDD.
The radiologist's report said the screws did NOT enter the disc area or a healthy disc, the surgeon has to work with what is available.
None of these surgeries can totally and permenantly FIX the problem and you may require additional surgery in the future, with the techniology available today although they make advances everyday.
The natural end result of degerative dics disease DDD is spinal fusion.
If/As the disc disintegrates, the space gets smaller, boom the screws become a problem.
Your OS referred you to the NS they must have some confidence in each other's competency.
The OS speaks a different language than the NS, and both speak different than the radiologist in technical terms at least, even different radiologist will interpret the images differently and many physicians assume the radiologist will positive report findings whereas they may only address a specific protocol or referal question.
Ask the NS if they feel it is malpractice and if they would be willing to testify against his colleague? Most likely they will explain the stats re success of surgery, none will be 100% and that with a degenerative condition, it is a matter of time before you may need another procedure, that is why they try to delay as long as possible, most likely this was a part of your initial informed consent before your first surgery.
I am sorry your surgery didn't provide relief for a longer period of time.

I just had a case with an extruded L5-S1 disc where some docs were recommending fusion. Two of the known risks of the surgery (which probably should have been discussed with you prior) are a "transfer" process where, even if the fusion is successful, the L4-L5 (and up) discs get extra stress "transferred" up to them thanks to the decreased mobility at 5-1, which frequently requires a second fusion. Also, pedicle screws are notorious for coming loose or otherwise requiring removal some time after installation.

It may still amount to malpractice though. Your best bet is to speak with a local malpractice attorney who can tell you for certain.

PS: It could be worse - bladder, bowel and ejaculatory control are also common complications.

Thank you for your replies. I am aware of "transitional syndrome", where the adjacent segment is stressed and can eventually fail. The statistics are 20% failure within 10 years. In my case, it was the pedicle screws that "harpooned" the disc and caused the dramatically rapid deterioration of the disc and the resulting acute slip of L4. In the xrays it is obvious that the pedicle screws were well into the disc from the very beginning. Anyway, I very much appreciate your input. This is a great forum.

parminus6 said:

Thank you for your replies. I am aware of "transitional syndrome", where the adjacent segment is stressed and can eventually fail. The statistics are 20% failure within 10 years. In my case, it was the pedicle screws that "harpooned" the disc and caused the dramatically rapid deterioration of the disc and the resulting acute slip of L4. In the xrays it is obvious that the pedicle screws were well into the disc from the very beginning. Anyway, I very much appreciate your input. This is a great forum.

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That is not what the report shows, you stated, "The L5 screws were noted to protract slightly in the area that appeared to be in the disc space at L4-5, but the screws were short and well within the pedicles and were not into the neural foramen or into the disc space." If they were sticking into the disc initially, you would have known it from the begining, unfortunatly you fell into the 20% where the proceedure fails, a known risk of the proceedure and settinging into play a cascade of degereration. Consult as advised re you options.