Our 15-year old son had spinal fusion for a high-grade spondylolisthesis. Evidently the surgery was a failure. The fusion didn’t take and the X-rays show movement where there shouldn’t be motion. What do we do next?

Your surgeon will be the best one to advise you based on your son’s symptoms and X-ray results. Failure to fuse is a problem in many cases of high-grade spondylolisthesis. Successful fusion can be difficult with that much forward slippage of the vertebra. It doesn’t seem to matter what method is used to do the fusion. Patients who are put in a body cast after fusion do seem to have better overall results.

The next step may be careful watching. If your son is not having any painful symptoms, then no treatment is needed. Watch for low back pain, deformity, or changes in the way he walks. Other red flags include hamstring spasm or tightness and neurologic symptoms like numbness, tingling, or weakness.

For the patient who has pain or any of the other symptoms described, a second surgery may be needed. The fusion may have to be done again. Metal rods and screws may be used if they weren’t put in the first time. The extra reinforcement may increase the chances for a successful surgery.