Hardware removal is a very complex and difficult surgery when it comes to the lower spinal area. The reason is the vast interlocking maze of scar tissue with muscle. So please carefully determine if the hardware is the only cause of the pain and it can be validated with tests, etc.
Hardware surgery in other areas of the body (leg after fracture, arm, etc) is much easier medically. Not nearly as complex as posterior spinal hardware removal.
Kross, what tests can determine whether or not hardware is causing the pain? I certainly don't want him going through this surgery if he is going to come out in more pain. The doctor did say that he almost hopes that he isn't fully fused and then he would add more bone so I'm thinking he doesn't prefer to take out the hardware.
I hate to post something that isn't encouraging, but I had my hardware out after my first fusion 30 years ago. It made no difference whatsoever in my pain. I also had a complication that I hadn't expected. I figured this was the easy surgery, compared to the actual fusion. But they apparently offended a nerve (nicked it? Who knows.) during the surgery. I had a numb spot on my back, a circular area a few inches across, following the surgery. Couldn't feel it at all. It wasn't a problem, didn't affect me day to day, just a bit alarming until I got used to it. Over a couple of years, the feeling gradually came back.
I'm getting some hardware out next month, but this time it should make a difference, since it's protruding and really hurts to lean on. I never thought I'd be saying I can't wait for surgery again! I'll be so glad to get it over with and be able to lean back again!
I think sometimes it's a last resort for pain relief if they just can't figure out any other reason for the pain. Maybe it will help. I hope so!
P.S. My current doctors have told me that I would probably have been much better off now if they hadn't removed that hardware 30 years ago. Just food for thought...
Last edited by BlueAtlas; 08-17-2007 at 03:49 PM.
Reason: Added my P.S.
I learned when your hardware can cause the pain:
MRI can determen if your hardware moved
Same test can determen if your hardware broke and presses on a nerve
If MRI does not show this - usualy your pain NON hardware related. Many Doctors are very against hardware removal, they believe it can cause more problems in a future + more surgery = more scar tissue which can cause more pain. So if his Doc wants to go in, he has to make sure what exactly he is looking for...
My boyfriend had a CT scan which was negative but he goes for an MRI next week so if anything is wrong, we'll know soon enough. Believe me, I don't want him going in for another surgery. We had a long talk with his surgeon and he said he would rather see less fusion rather than remove the hardware. There are no guarantees that either of these procedures will relieve the pain but my bf doesn't have much of a choice right now. He is in too much pain and has to try something. He can't live this way. Its really stinks when your back is up against the wall and you have no choice.
Lynne, I was interested to see what people would say. I'm seeing 2 doctors next week and hopefully another one or 2 to get their opinions. My surgeon put in hardware that is apparent waaay too big. I have been complaining of continued pain - just like before surgery and finally the surgeon ordered an MRI and CT. He (of course) said there is no reason for the pain. My pain dr., GP, PT, and the medical assistant making copies of the images gasped in horror - honestly! - when they see how big it is. My spinal cord is more compressed now than it was with the herniated disc. Someone else said they can't believe they're saying they're looking forward to surgery again. I'm hoping removing or replacing this hardware will help me.
Please stay in touch with what the doctors recommend and why. It really helps to know what questions to ask and for food for thought.
Have him ask his doctor to perform a hardware block (hardware injection).
I haven't done this personally, but have known others that have, the hardware block was very beneficial in determining if the hardware was indeed actually the cause of the pain.
Here is a brief explanation of how the block works:
Your doctor may need to determine whether the metal hardware that has been used during surgery could be causing your discomfort. A hardware injection is performed by injecting lidocaine alongside the spinal hardware that was placed in the spine during surgery. If the pain is removed temporarily by the injection, it may indicate that the hardware is causing your pain.
These injections are used to determine whether a specific piece of hardware is causing the pain and needs to be removed surgically.
i feel for you, guys... Who wants to have a surgery especially a spinal one if it' not a must. And i know how devastating this is when you don't have answers. Good luck to you and him and I hope something will be done that can help his pain.
Please, keep us posted. Besides we want to know how is he doing, this may help a lot of people to get their questions answers.
I had a hardware block today and I am hoping for positive results. They have tried so many different areas that haven't worked. In the last 3 years, I have had one injection that actually worked and of course he can't find the same exact spot now. However, I had stitches removed today from a failed scs and we went back to the basics and the doc and I both feel we found the source of my primary pain today. Take all of the recommendations from this board, they are truly the wise ones.
My bf's MRI is tomorrow. This is to look at the 3rd level. I guess the surgeon doesn't want to do discogram and put him in more pain. His CT that was done in ER had come back negative. It shows fusion but the surgeon explained that CT scans aren't alway perfect. What may look like one bone could be two if they are lying on top of each other. I'm calling the surgeon tomorrow to ask about the hardware block. My bf had a similiar block done to check his hip pain a little over a year ago. He has torn cartlidge in both hips and avascular neucrosis. The block stopped the hip pain. My question is if the dr does a hardware block how do you really know if the pain is coming from the hardware or a muscle or something else in that area? Of course the lidocaine will numb the pain but how can anyone be sure that the hardware is the reason?
Thanks for all your support here. It means so much to have a place to talk these things out and get advice.
I honestly don't think there is any test thats going to show if the hardware is causing pain. If you press on my hardware it hurts ! It feels like a bad bruise. My surgeon was planning on removing mine at one point until he said I wasn't fused enough . Some people have a reaction to metal in their body . Maybe this is his problem ? It sounds much more like somthing else is wrong. the metal shouldn't be causing that much pain . I wouldn't think so anyway ? I wish him luck and hope it works.
Yes, Shawley is right: unfortunately no tests which can show 100% what exactly is wrong and if this is hardware causing pain. So sorry you both have to go through this.
Just would like to add: he is so lucky to have you. I can feel how much support he gets from you and how much you care.
Good luck to you, guys, hope the answers is almost here....
I am going to have my hardware out, if I have to pay for it myself. The hardware I have is temporary and according to my doctor and the maker of the hardware, it is temporary. Two years out and the insurance companies involved are still playing games. When my hardware pressed on, it hurts like crazy. I just spent another 5 days in the hospital. Swelling in my legs and extreme back pain. According to the hospital, no heart problems. Thank God. According to another hospital the pain is coming from the back. I try to sleep on my back and I feel the screws, on my stomach and it feels like the rods are keeping me to straight. I have a second opinion coming up from insurance company #1. I guess it will be the same story again, to old, to out of shape. This isn't even the insurance company that paid for the surgery. Hardware removal surgery is only an overnight stay. It would only produce surface scare tissue as no cutting involved in the vertebre area. Mine will be more cutting as they are going to do cutting on spurs and enlarging nerve canals to stop the entrapment of 3 nerves. I have so many different opinions on hardware removal. I hope the removal is the solution to my pain and everyone else that is considering removal of the hardware.
I had my hardware removed 11 months after my first two level fusion. After about the 5th month post op I started having MAJOR pain again, the xrays didn't show anything wrong so after many more months of pain they went in and 2 of the screws were so lose they could wiggle them with their hand. It did improve the pain levels after they got them out of there. The screws were wiggling everytime I moved so it was making the holes bigger everytime I moved too. I hope you get your problems solved soon.
"Thru every dark corner is a door to a new light"
We will know soon enough what is causing my bf's pain. His surgery is on September 4th. The surgeon did say that the screws could be the reason if they are knocking around the bone. But whatever the reason is, I am confident that he will find the problem and fix it. Thanks for everyone's input and support here. I will keep you all updated.
good luck to him! I think this is great that you are confident, this helps a lot. It has to be the reason WHY his is in so much pain, just depends on Dr. to find that reason.
Will be thinking of you, guys. Keep us posted.
Chris, after reading your posts i asked my Dr about hardware removal,and if my hardware has expiration date. He never heard about temp.hardwear and does not believe that hardware can cause any pain unless something gets broken or loose. I am so sorry you have this problem, sounds so painful and frastrating.
Best wishes to you - i hope they will find what is the problem.
I was told up front that the hardware would more than likely have to be removed because of its temporary rating. My sister-in-law had her hardware removed after 1 1/2 years. She had a one level fusion by a micro-sergeon in Ok. For some reason she had fluid build up and had to have the hardware removed to see if the swelling would go down. She said that the fluid was gone and also the pain was gone as soon as the hardware came out. She kept the hardware just to remind herself what was hanging off her back. When I ask my doctor if the hardware is causing pain, he pushes on it and ask, Does It??