Patients with persistent pain after lumbar fusion frequently have an unrepaired annular tear at an adjacent level or a new tear that has formed at the level above or below the fusion. Intra-annular fibrin injection addresses these tears directly without requiring a second surgery. Imaging review confirms which discs can be treated.
Key Takeaways
- Adjacent-segment degeneration is a recognized long-term consequence of fusion.
- New annular tears commonly develop at levels adjacent to fused segments.
- The fibrin procedure treats discs unaffected by surgical hardware.
- 80% of patients with prior failed surgery reported positive outcomes in published cohorts.
- The procedure does not require revising the prior fusion.
What This Guide Covers
- Why does pain sometimes return after fusion?
- What is adjacent-segment degeneration?
- How does fibrin treatment fit after fusion?
- What does post-fusion evaluation involve?
Why does pain sometimes return after fusion?
Pain after fusion returns or persists for several reasons: adjacent-segment degeneration, new annular tears at non-fused levels, hardware-related pain, scar formation, or pain drivers that the original surgery did not target. Identifying which is active in a specific patient is the first step.
What is adjacent-segment degeneration?
Adjacent-segment degeneration is the accelerated breakdown of discs above or below a fused segment. The fusion eliminates motion at the surgical level, and the adjacent levels absorb the additional mechanical load. Over time, those adjacent discs commonly develop annular tears, height loss, and other degenerative changes.
How does fibrin treatment fit after fusion?
The fibrin procedure addresses annular tears at discs unaffected by surgical hardware — commonly the levels above or below a fusion. The procedure does not revise the fusion itself; it targets the lesion driving current pain. In published cohorts, 80% of patients with prior failed surgery reported positive outcomes.
What does post-fusion evaluation involve?
Evaluation includes review of pre- and post-fusion imaging, the operative note, current MRI, and a focused exam. The Valor team determines whether current pain is driven by adjacent-segment lesions, hardware, scar, or another pattern. Treatment recommendations follow from that finding.
Clinical Note
Post-fusion patients are one of our largest single populations. Many arrive having been told their pain is “the price of having had the surgery.” Our clinical staff treats that framing as incomplete. Adjacent-segment lesions are real, identifiable, and treatable in many cases. The fibrin procedure does not undo a fusion or revise it — it addresses the new lesion at the adjacent level. For patients who fit the imaging pattern, that distinction is the difference between learning to live with the pain and having a path forward.
Frequently Asked Questions
Can the procedure be done if I have hardware in place?
Yes, when treatment focuses on discs unaffected by the hardware. Imaging review confirms anatomic feasibility.
How long after fusion is the procedure considered?
Most patients are eligible to evaluate the procedure once they have completed standard post-fusion recovery and have continued symptoms.
What if my pain is at the fused level itself?
The procedure does not address pain at fused levels. The evaluation determines whether a treatable adjacent lesion exists.
This content is for general informational purposes only and does not constitute medical advice, diagnosis, or treatment. It is not a substitute for evaluation by a qualified physician. Treatment decisions depend on your individual medical history and clinical findings. Schedule a consultation to discuss whether the procedure is right for you.
