I had another fusion in Feb. this time the L3-4 with rods and screws. I know that if something breaks, or if there is infection, the hardware can be removed. I am wondering if it is removed for any other reasons? I am having a lot of trouble with inflammation, probably from the hardware and wonder if anyone else has dealt with that kind of inflammation and what was done? I had a caudal injection 2 weeks ago....it was one inj. too many and I am now dealing with high blood pressure. I'm just curious to know if the hardware is ever removed for anything other than breaking or infection.
According to my surgeon we are going for the removal of the hardware because it is considered temporary until the fusion is complete and then needs to be removed. The FDA has not approved it for perm. use. Right now my removal date is pending. Also the doctor feels it is causing most of my pain in my lower back as it can cause problems from the tension and also the tension on other levels.
They can do a nerve block around the hardware to determine if it is the hardware causing the problem. I had one done and the results showed that the hardware is part of my problem. My doctor is ordering a mylegram with the CT to determine if the fusion is healed; however it is never a complete guarantee and you don't know until you are inside 100% what the case is. From there we will determine if I need a anterior/posterior fusion of L4 and removal of hardware of L5, etc.
My doctor said if you are not fully fused and the hardware is removed it can cause the vertebrae to sometimes slip forward/fall into the level below causing more problems. He also mentioned removing the right side hardware only which can cause more stress on the left side but it would remove the offending hardware.
So the long and short is that yes hardware can be removed for pain, nerve compression, if the hardware is catching on the next vertebrae level above or below and inflammation.
Hope this helps and is clear because my meds are kicking in.
My surgeon never mentioned removing the hardware. I never asked either. Now that he thinks scar tissue is pressing on the nerve, I don't know what the next step is. Would not look forward to that surgery.
I had my hardware removed because of loose screws (hubby loved that one) hehe! but it can be removed if it is not being tolerated very well. My first set of hardare bothered me from the begining. This second set of hardware isn't bothering me no where near like the other one did. Not sure why that is.
I hope you can get some relief without the removal. I just had the injections to try to help my pain levels but it didn't help at all either.
"Thru every dark corner is a door to a new light"
I just had hardware removed because it was protruding. I've heard of people having allergic reactions to it, too. 30 years ago, my hardware was removed because my doctor felt it would be better for me to not have all that metal in there if I was ever in an accident. In retrospect, he never should have taken it out, but I think he did believe he was doing what was good for me at the time. There are a lot of reasons they do it.
The good news is, it's a much easier surgery! I'm two weeks out as of yesterday, and I'm just a little tender back there. Driving is still a bit uncomfortable, but getting better each day. Other than that, I'm back to what I was before the removal, except I don't have that thing sticking out when I lean back anymore. Yahoo!
My surgeon said from minute one in the pre-op, that the instrumentation would be removed at 18 months post op. I am nearing that now. I was fused from L2-S1 and the screws only bug me occasionally, so I will push the having them removed for as long as I can. A good friend in England had the same surgery and they don't remove the hardware over there.
Lgrove that is interesting because when I first had my fusion done, my surgeon said that Kaiser would not allow them to be removed until I was 18 months out from surgery. Then after my surgery he said at least 12 months. Now that I am having so many problems he is saying I might be okay at the 9/10 month point. First he is ordering the mylegram to check on the fusion.
I had my hardware put back in 10 months after they removed the first set. There was no room for new holes so they had to wait until the old holes filled back in. Now you would think if the holes filled in that the BMP would have done the same, but NOOOOO I never did fuse. The vertebra moved again and I had to get then second set of hardware then.
Emily, I'm so glad that your doing so well after the removal surgery.
"Thru every dark corner is a door to a new light"
Last edited by mamakitkat; 10-10-2007 at 10:18 AM.
I am reading all your posts with my eyes WIDE open as I am looking at a second surgery. I'm in process to get 3 opinions. It seems like they all have a range of different approaches and philosophies. Please keep posting with your experiences and appointment updates.
Just FYI for my situation: my surgeon originally placed a right lateral plate and 2 screws and a cage at T6-7 in 2/07. Since that hasn't worked, he recommended to make the foramen bigger and place more stabilizing hardware on the left side in 9/07. Now that he's "reviewing" the images and sees the funky bony growth from the cage is impacting the thecal sac, he wants to replace the cage only with a minimal invasive.
Doctor #2 doesn't want to do anything and just manage pain (which hasn't been going great, but...)
Doctor #3 tentatively recommended to do a thoracotomy to really evaluate the condition of everything and go from there, contingent on the results of the CT/myelogram.
I hope keeping our heads together we'll make some sense of this!
Gosh, I wasn't expecting so many responses. I thank each and every one of you!
I do know that I am fused. Also that I had spondylolithesis and that was "fixed" too....not sure on how that do it, other than it is part of the fusion. Since around June (Surgery was in Feb.) I've been experiencing a lot of inflammation in my lower back. I don't know if hardware is the cause of it or not, but when I next see my ortho we are going to have a talk about it.
I can't remember which of you said that your dr. told you it is routine to remove the hardware after a certain period of time, whether or not it is causing problems. What harm could there be to leaving it in if it isn't problematic?? Also, someone said that the removal surgery was much easier than the original surgery.....anyone else have that experience?
I hope responses keep coming; I am learning so much.
Wow, pepper, that is so good to know. I don't know what the future holds and I'm praying that this inflammation quiets down and surgery won't be necessary. What I find confusing is that my specialist never mentioned any necessity to remove that hardware....I wonder if he simply feels it isn't necessary until or if it starts causing problems. Guess I'll find out in December, unless things change for me.
Pepper, x-rays show complete fusion; there was some fusing already at 8 weeks and at 6 months, it was total. I've had a 2 level cervical fusion, and 2 fusions at L5-S1. The first one was destroyed in a car wreck. Even tho I'm a smoker, and I have osteopenia, I seem to have been very lucky with fusing quickly. Perhaps that's one reason I've recovered fairly quickly from these surgeries. May God stay with me!!