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Old 07-13-2009, 09:36 AM   #1
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Newbie in desperate need of help/post fusion misplaced screw?

Newbie in desperate need of help please . .

--------------------------------------------------------------------------------

Hi All,
I hope to goodness that someone here can help me,im at my wits end.
I had PLIF at L5/S1 Sept 2007 due to DDD
I was fine for a matter of weeks and then slowly but surely my symptoms are returning,even though they have confirmed a fusion.
I have managed to obtain all my medical records,the xray taken 1 day post op seems to show the L5 right hand screw entering the vertebrae and it goes upwards and seems to go through the top of the vertebrae and into the disc space above.
IS THIS A MISPLACED SCREW?AND SHOULD IT BE THERE.?
i have had 2 MRI'S since but they were only checking for the fusion.
i was sent for another xray last week as i have not had one in 2 years,and my doc specifically asked them to check position of screws.
They reported a fusion,but no comment on the screws at all.
When my doctor rang the radiologist today to ask the question he said he couldnt really comment.
Should this screw be there?
i am worried about approaching my neurosurgeon as i think he'll just say its fine.
I am recently married,and this back problem has stolen the last 3 years of my life and im desperately trying to stop the frequent lack of bladder control,constant pain,and my legs being blue,blotchy and freezing cold as they were prior to my op.
It feels like no one will give me a straight answer,im not looking to get anyone in any sort of trouble im just desperate to get my question answered as everyone seems to be skirting round the issue.
Please help . . someone

 
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Old 07-13-2009, 07:40 PM   #2
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Re: Newbie in desperate need of help/post fusion misplaced screw?

See if you can get copies of all of your x-rays and then start with consulting with your primary care physician (if possible and if you find he/she to be helpful). Then perhaps a referral to another Orthopedic Spine Surgeon or Neurosurgeon.

Eons ago I had knee surgery and only found out the error that was done in screw placement when I requested copies of all x-rays and had my primary care physician review the x-rays. I then got to the right doctor to fix the problem.

Also, if you get the copies you may be able to see yourself the position of the screws. In most cases the screws should be in the middle of the vertebrae (and not sticking out anywhere). I have old lumbar x-rays and new ones as well and my hardware is very visibly in the correct position.
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Old 07-14-2009, 04:46 AM   #3
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Re: Newbie in desperate need of help/post fusion misplaced screw?

Hi,thankyou SO much for your help,i really appreciate it at this time as i am feeling very low,and in a lot of pain with it all.
I have got the xray taken 1 day post op,and i had L5/S1 fused.what looks to have happened is that the screws in S1 are as you say,in straight.
The left screw in L5 is fine,but the right side looks to have clipped the top corner of L5 and is exiting the top centre of L5,only by a few threads into the healthy disc space above.
I have had a reccurance of my original symptoms,pain,although not as intense but is slowly getting there,freezing feet and bluish discolouration on my lower legs.
I showed my GP the xray as he had never seen it,and he sent me for another one last week,speciafically asking if my problem could be down to a misplaced screw,and they just confirmed that fusion has taken place,.i already know that,thats not where the problem is! He wouldnt say it WAS misplaced,but didnt say that it WASNT either.
It looks from the recent xray that the right hand screw on L5 is actually pulling out now as the rod is angling backwards.
We are unsure whether the screw is actually through the vertebrae or has broken free as it was just in on the corner.
Please keep the ideas coming,everything is helpful to me,and is really helping to keep my spirits up
Thankyou

 
Old 07-14-2009, 02:53 PM   #4
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Re: Newbie in desperate need of help/post fusion misplaced screw?

Any chance you can get a consultation with an entirely different neurosurgeon or orthopedic spine surgeon? Not sure how that works in the UK. Maybe going to an emergency room if no one will really address it with you? If they won't comment on the screw it makes me think they are trying to avoid the issue.
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C5-C7 foraminotomy 08

 
Old 07-15-2009, 02:57 AM   #5
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Unhappy Re: Newbie in desperate need of help/post fusion misplaced screw?

Thankyou once again for your help,

Im starting to think along those lines myself.
The surgeon sent me for 2 MRI'S to check the fusion itself which as i already knew was not causing me the problem its above that,but didnt comment on anything else.
The surgeon was not at the hospital the day after my op,when the 1st xray was taken,and as far as i know he's never seen it.
The big problem is,will he address it?or say its not causing me a problem.?
mmm,think the latter.

I think that a different neurosurgeon is the only way forward for a second opinion,if i had come out of hospital like this id accept it,but my condition has deteriorated in the last 18mths since my op,ive only been sent 1 follow up appointment to see my surgeon,which was 10 months! after my op,thats the first time he saw me,he added diazapam and neurontin to my array of pills,he's been contacted by my doctor twice,as ive gradually been getting some urinary incontinance,and recurrance in freezing feet,and discouloration etc,as before.so he sent me for routine MRI,but we've only just found the issue of this screw since i received my xrays earlier this week.
As it stands now my doctor GP,is waiting for a call from the radiographer at the hospital where i had my xray last week.He's meant to be comparing the 1 day post op xray,and the latest one taken last week.
Im pretty sure he's not going to comment though,its just an entire catalogue of errors,
and im losing hope . . . fast.

thankyou so much

 
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Old 07-15-2009, 04:51 AM   #6
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Re: Newbie in desperate need of help/post fusion misplaced screw?

From your description, I would say that it sounds as though the screw is misplaced and now is backing out of the vertebra. The rod moving backward is a good indicator that there is something wrong with the placement of the screw in question. Getting a radiologist to admit that there is a problem with the placement of the screw might be a bit difficult.
When I had my fusion and there were problems with the screws, I was told by my original surgeon there was nothing wrong, and until I sought out the opinion of another surgeon who was not related to my original in any way did I find out that two of the screws were backing out and needed replacement, as well as the fusion not taking.
The problems with your bladder at this point, need addressing, probably by a competent neurosurgeon and not the one that did your original surgery. It is difficult at times to find a new surgeon who will assume care for you, after you had surgery the first time with another but they are out there. You may have to look a little harder, but they are there.
Best wishes,
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