Should I Remove My Lumbar Screws and Rods? Broken Screws.
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- čas přidán 15. 03. 2022
- When is it safe to remove hardware from the lumbar spine? When should you remove the hardware from the lumbar spine. A short video explaining the risks and benefits of removing lumbar hardware.
I got my L4 L5 S1 fusion done five years ago and to this day surgery whenever I sneeze or cough I have to brace for it. Otherwise it hurts like hell and brings me down to one knee. I swear, I think the hardware is poking at the nerves in my surgical area.
I´ve been 11months post l4-l5 l5-s1 MIS TLIF and I´m still experiencing pain in the left side of my back. it just doesn´t go away. But the CT scan says that everything is in place. I truly believe that there´s something irritating my muscles and nerves and probably can be the instrumentation so I will talk to my surgeon to see if there´s any chance to take the instrumentation out. My question is: How long does it takes the recovery of the removal? I just don´t want to go through another long period of recovery time so that´s my concern. I´m 28 pretty active activity. Thanks.
I really appreciate your video. Very INTERESTING, to say the least.
I have a question or three for you, doctor. In March 2016 I had a 3-level fusion cage surgery on S-1/L-5 - L5/L4 - L-4/L-3. The disc material between L-3/L-2 was about 50% gone and the ortho surgeon elected to NOT put an artificial disc in that segment. Rather - extend the rods and screws higher to keep pressure off the disc.
Doctor used two rods - two plates and screws to hold everything in place outside my spine. Surgeon ground down facets and used the powder of them to be part of my inserted discs, if not all. Don't remember now.
Doctor told me he felt he could give me about 70% OVERALL relief of my back pain prior to surgery. That percentage was considerably higher than what 5 other very prominent ortho surgeons promised me in the Grand Rapids, Michigan area. (University of Michigan refused to do surgery on me, as did the 5 local surgeons).
There was considerable relief from back pain for about 1 1/2 years. Then slowly it started increasing. After three years I went back to the surgeon who did my operation and asked him if there was anything he could find to help reduce my pain. He told me the MRI and x-rays he took of the area showed everything was in place as it should be. "So there's nothing I can do for you ... other than recommend you try some sort of an implant that sends electrical signals to the spine area." (I forget the exact name of the procedure, [not a Tens unit; but similar in purpose] but it didn't look all that attractive to me, and so I've never seen him again).
Doctor told me what I was experiencing was S-I joint pain. (Little more about that below).
Now what I find VERY INTERESTING to me about your video here is that my surgeon said NOTHING about the possibility of having my rods and screws and plates one day removed, IF I qualified. NOTHING was said about it, so I just assumed the hardware was intended to stay inside me until I died. But YOU indicate maybe NOT so????
Although I don't have discs moving in and out constantly like I had before my surgery, my back pain has consistently began getting worse over the last three years (six years after the surgery). I can only stand on my feet for about 30 minutes and my legs get so heavy I have to lie down. Yep - all the numbness and weakness in the legs, but that hardly left after the surgery).
I've read extensively on Doctor Google that with as many discs that I had fused, especially the L-5/S-1, it's normal for trauma to move down into the S-I joints to act as the new "shock absorbers" I had one S-I injection from the side that radiates the most pain and it worked quite well for a couple of months. Then wore off. I had two more in the same area and I left the clinic with more pain than what I went in with. Decide NO MORE injections.
So now comes my question/s. Is it possible that if I had my hardware removed, might I receive a lot of freedom from the back pain I live with now day and night?
And would you recommend I NOT go back to the same surgeon who said NOTHING to me about the possibility of one day having the hardware removed, because I neither really would need it ... or it might be causing me undue pain? He is a highly rated spine surgeon according to many I spoke with, but personal recommendations can be quite "relative" I realize.
Thanks for any suggestions you might care to offer.
AND - if you have an ortho surgeon in the Grand Rapids, Michigan area you might recommend in checking me out, I would surely appreciate it. I would be willing to travel further if convinced it would be worth my time.
The most common reasons you would have pain after a long fusion include: assuming that there is no problem with the fusion itself and it is a solid fusion with no residual impingement.
1. Breakdown above the fusion which is typically treated with a fusion and decompression.
2. Breakdown of the SI joints. Usually diagnosed with x-ray CT and bone scan. Treated with a fusion of the SI joints
3. Symptomatic hardware. Typically treated with removal of the hardware.
4. Post laminectomy/fusion syndrome. Pathology from previous surgery not correctable with additional surgery. Typically treated with pain management and devices such as dorsal column stimulators.
Without having access to your studies it would be impossible to know into which category you fall. If everything else is negative and your pain is mostly in the lower back over the instrumentation then you might be a candidate for metal removal.
Normally I would think it best to go back to the original surgeon. Just be aware of the fact that the original surgeon is always going to be most interested in proving that his original surgery was done well and not necessarily look for secondary causes.
Thank you for the email. If I can be of any other assistance please let me know. I hope this information has been of some used to you.
@@Elpasospinecenter Thanks SO MUCH for getting back. You don't know how much this means to me.
Hello Dr.Dean. My spine is fused T2-L2, and since then my lung capacity has been lower. is this something that hardware removal can help with? I also have a lot of pain in the lower back under L2. thank you
My sister spinal surgery happen , and after operation some weeks after she gets sensation lightly when we rub on lower body with a hard rub,, now one screw was broken and operation after can she able to walk and and get motion and urine sensation
Do you suggest Bracing after Lumbar Fusion and bed rest or walking with no Brace? I had a failed fusion we assume I have micro movements so in pain when bending. It has been 2 years since fusion, I should be going for revision in about a 2 months.
I recommend avoiding braces and normal activity. Braces have shown that biomechanically they increase the amount of stress on the lumbar spine. Also Braces rest the muscles in the spine and lead to muscle atrophy with a net result of more stress on the spine. Bones like activity and stress according to Wolffs law. Do you want to avoid stress on the bones. Direct compression is good. You want to avoid sheer and twisting. No brace. Normal activities. Minimal lifting and no lifting and twisting. Want to use good body mechanics and keep your shoulders and pelvis in the same line.
@@Elpasospinecenter Thanks for the reply! I had L4/L5 fusion from the back, 2 years ago this April after a re rupture of the disc after a discectomy a year and 1/2 before that, and although all the sciatic pain is gone, when I do anything where I bend over or my spine moves I get shocking pains in my back. Rest usually gets me back to pain free. Just sitting and shifting my hips front to back, side to side I get pain.
If I lay on my back I am usually pain free and can sleep in most positions, sometimes laying on my stomach will cause pain. The CT is said to be vague as to whether I got enough bone growth. After the last Fusion I was off all meds and tylenol day 3, and was walking day 2. I am hoping the revision will fix the pain so just looking at doing whatever I need too to get that bone to grow. Non diabetic non smoker, non drinker and not over weight. Don't take supplements or use pain meds even OTC unless I really need them. Any advice would be great. For the Revision surgeon said he would probably go in again from the back remove the old hardware, use bigger screws and I assume use another cage and bone graft.