Tuesday afternoon, we helped Virginia, who is a 64 yo woman, who came up to see us from Florida (near Sarasota), with severe back pain and trouble walking.  She had a previous L4-S1 noninstrumented fusion done 30+ years ago, and had done well for many years.  Over past few years, however, she developed increasing low back pain and trouble walking.  Her studies show severe adjacent level failure with degeneration and stenosis.
Tuesday, I took the pressure off the nerves at L34, (laminectomy) and extended her fusion from L5 up to L2, with instrumentation and bone graft.  The intra-operative photo shows a piece of the old fusion mass that I had taken from her fusion.  You can see how solid her old fusion became, now as solid white cortical bone on the outside shell, and cancellous bone in the middle of the fusion mass, similar to what you would find in the middle of a vertebral body.  It is truly amazing how the body heals, especially bone, since bone heals without the scar found in other tissues like skin.  In about a year (or less in children), the bone graft that I put along the spine from the local spinal tissues, and from the bone bank (allograft), turns to this very solid normal human bone, providing long-term stability along the fused segments.

Virginia did VERY well during her visit here to Raleigh, NC and Duke Raleigh Hospital.
She drove home to to Florida, leaving early Saturday morning, with plans to make one overnight stop on the way home.
She planned to sit in the passenger seat, semi-reclined, and to make stops every couple hours to avoid getting stiff and blood clots (deep vein thrombosis –DVT)

Lloyd A. Hey, MD MS
https://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh NC  USA