[Spinal Fusion / Lumbar] Remove the screws? (Screw Irritation Post-Fusion)

[Beth]

I had a severe trauma and had a L2 fracture with a corpectomy. 2 weeks later he went back in through the back and fused L1, 2, and 3. I do walk, and have been doing some yoga. I'm on the lowest dose oxycontin for the pain. It is primarily neuropathic pain, but I do get a severe amount of pain near the surgery site also.
At my visit on Tuesday my neurosurgeon said that the fusion had fused. But he believes the screws are
causing irritation to the nerves around them. He want to remove them.

My question is has anyone had this surgery before. He says it will only be overnight in the hospital and I can go back to work the same day.

Anyone else experience this surgery?

[Greg]

I had a severe trauma and had a L2 fracture with a corpectomy. 2 weeks later he went back in through the back and fused L1, 2, and 3. I do walk, and have been doing some yoga. I'm on the lowest dose oxycontin for the pain. It is primarily neuropathic pain, but I do get a severe amount of pain near the surgery site also.
At my visit on Tuesday my neurosurgeon said that the fusion had fused. But he believes the screws are
causing irritation to the nerves around them. He want to remove them.

My question is has anyone had this surgery before. He says it will only be overnight in the hospital and I can go back to work the same day.

Anyone else experience this surgery?

Sorry to hear of your troubles I guess they did a posterior fusion on you? I havent heard of the hardware being removed before but I always thought that they would do that after the surgery....it seems like they would kind of be in the way. I'm sorry I dont have the answer you need but wanted to wish you the best of luck and if the surgeon thinks this needs to be done than he probably has good reason to want to do it.

I would check with some other surgeons and get their opinions about removing the hardware if you still feek uncomfortable about it. It's your body and your decision to make so make yourself confident and comfortable in whatever path you take. Good luck and hope everything comes out alright....no pun intended

[Cindylou]

Beth, I haven't had any screws removed from my fusions, however, I agree w/ Greg....I would get a couple other opinions from other docs before I made a decision. I'm sorry you are still struggling with the pain post surgery. I hope you find some answers and relief soon. Hopefully, someone will chime in if they have had this particular surgery.

My best to you,

Cindylou

[KBear]

I agree with Greg and CL- get a few more opinions before deciding. It makes sense that they could be causing problems, but I would definitely make sure I was 100% sure before going back in.

[Job13]

I read on HealthBoards forum a lot about hardware removal (screws/rods) after a fusion. Some people seems to have irritation around metal and if "painful hardware test" confirms that metal indeed generates the pain, then your surgeon can remove rods and screws. It can only be done if you have a solid fusion.
I read on mentioned above forum and also I talked with a couple of doctors: the general opinion is that skinny people (generally women with small muscles) are more likely to have painful hardware. My understanding is that hardware is lying down on muscles. If one doesnt have an extra layer of "padding" (fat tissue) or huge developed muscles like strong men might have, then hardware might be rubbing on those muscles, creating pain. But sometimes it doesnt matter how much fat tissue one has, the body just doenst like metal sticking into the flesh.

Here is also a couple of articles:
"Dr. Nottingham noted....that in general, thinner patients tend to benefit more from instrumentation removal surgery because they appear to have greater displacement of muscle and surrounding soft tissue than do heavier patients."
http://www.painmedicinenews.com/index.asp?section_id=84&show=dept&issue_id=122&art icle_id=4339

"Of the many patients who undergo surgery for chronic back pain, as many as 15 percent may need a second surgery to remove the hardware (screws, rods) that was installed."
Considering Removal of Implants if Back Still Painful After Lumbar Surgery | eorthopod.com

[runagain]

Beth,

I have had friends on other boards who had fusion and did have their hardware removed.
Most were successful and some not.
Remember it is a surgery and there are always risks with any surgery.
I think it would come down to a cost vs. benefit ratio. I.E. is the hardware bugging you so much that it is making you miserable or it is not bugging you so much. The cost is the surgery and the benefit is the pain relief.

Good luck and best wishes with your decision.

[Rob]

Hi Beth,

I just had my '12-week post-op check-up' last week (actually 14 weeks post-op). I had an ALIF on L4/L5/S1 with posterior rods & screws. Most of my surgecal pain seems to have subsided, and the back pain I used to have, prior to surgery, seems to be much better. However, I still feel discomfort / pain in and around the posterior incisions. I beleive it's the hardware.

I discussed this with my surgeon last week. He noted that I should wait to see how I feel at the 6-month post-op mark. He said he can remove the hardware, and noted that he has done it before. He also noted that it seems that thinner patients seem to feel the hardware more and typically the problem is they feel the heads of the screws. My discomfort / pain isn't the heads of the screws so much, I beleive its the whole aperatus and the interaction with the muscles. I feel quite a bit when I roll over in bed or if I walk a lot.

He concluded by saying that if I want them out I would have to wait until 9-12 months post-op to have the surgery so the fusion wold be solid. He said if I had the surgery in the morning I would probably go home that afternoon; if I have the surgery in the afternoon they would probably keep me one night. The way I feel about it right now is that I will want it removed.

Hope this helps.

Regards,

Rob

[Greg]

I hope it doesn't have to come down to getting surgery to remove the hardware but nobody knows your body better than yourself. You still have a couple months to hopefully fade away the discomfort though. Did your doctor say you have to wait until 9-12 months for removal or could he do it earlier if you had a good solid fusion? Some studies/articles I've read lately talk about removing hardware (especially in skinnier patients) and say they could do the operation at 6 months as long as a good fusion is in place. We'll just keep our that you don't have to go down that path but it's good that your being proactive and getting prepared in case it is needed. Good luck to you!