I had a 360•fusion at L4/5 10 years ago. I never got a lot of relief in my back from it . So I have chronic back pain mostly on my left lower back & weakness & pain down my left leg. Right side also hurts but not near as bad as the left. I recently had to have anterior cervical discectomy fusion at c5/6 & c6/7. The ns that did my acdf says that he thinks the hardware in my back is what's causing my pain in my lower back. I have 5 screws. He said sometimes your body reacts to the hardware as a foreign object( which of course it is) . I afraid to have it done because what if that's not the problem. I mean it definitely affects my daily life & has for the last 10 yrs. I don't know if I can stand another surgery!! But maybe that's because I'm only 5 1/2 weeks post op from acdf? Anyway I was just wondering if any body on here has ever had hardware removed after fusion & if so did it take care of the problem?!
There is a procedure you can have called a hardware block that is similar to having a lumbar ESI that can give the surgeon a fairly good idea if the hardware is causing the pain.
The hardware block is a freezing injection into (near) the level where you have the fusion. You are then asked to do all the activities that normally cause pain. If you have pain while doing these activities, it means that something at another level is causing the pain, and it is not the hardware. But if you are mostly pain free immediately after the injection, you will be asked to keep a journal, noting when the pain starts to return, what you were doing at the time, etc.
I personally have not had my hardware removed but people who have tell me it is an easier surgery...usually overnight in hospital and then a much quicker recovery than the original surgery.
My hardware removal was outpatient, but I think that's because as soon as I woke up I was saying I want to go home. It resolved a great many of the problems I was having. I still have pain and will forever. It is nowhere near debilitating anymore, but there. I had two hardware blocks before the surgery just to see if the hardware was causing pain. My insurance required the second block before surgery to make sure it wasn't a fluke that the first one worked. It was a much easier recovery. I was back at work before 3 weeks, and I have a very physical job.
I had the hardware block and also a ct with dye to determine if the screws were impinging on a nerve. My doc decided against removing the hardware. I had had dye injected in the disks at L5/L4/L3 while receiving a ct and it showed abnormalities in my L4/L3disk I believe. I almost hopped off the table when he injected that disk which was a good indication there was a problem. You may ask about that if it's an option for you.
@ tetonterri66 thanks for the information! I had never heard of that freezing thing before.Of course when I went back to my ns after he ran his tests, he said he wanted to take care of my back but that my cervical stenosis was top priority. So when I go back in April we are going to discuss it further. Just not real sure about any more surgeries.
[QUOTE=Bradleyh100;4937908]I had the hardware block and also a ct with dye to determine if the screws were impinging on a nerve. My doc decided against removing the hardware. I had had dye injected in the disks at L5/L4/L3 while receiving a ct and it showed abnormalities in my L4/L3disk I believe. I almost hopped off the table when he injected that disk which was a good indication there was a problem. You may ask about that if it's an option for you.[/QUOTE]
Was the hardware in your lower back? Did you already have fusion? I was just wondering because you said when he injected the disc- was it disc that was close to your screws? So if you never had the hardware removed, do you have a Lot of pain in your back still? Sorry so many questions, I just feel like when I get in the ns office I forget what my fears were until I leave . even I write the down I get too involved with what he's saying I guess. Anyway thanks for the info!
I had the disk completely removed at L5-S1 and fused. I was off of meds in ninety days and felt great for about three yrs. Started having pain in 07 and returned to the surgeon who sent me for the hardware freeze which did not help with the pain. I then had the dye injected in the disks above the fusion. One of them caused pain in my hip when they injected it and my doctor said that showed that it was symptomatic. They did a ct while I was getting injected and that same disk showed an abnormal dye pattern that bulged out of the nucleus. My doc also was amazed at my bone growth. He said I was the best bone grower he had ever seen. The fusion was so solid that he didn't think it would be wise to try to remove the hardware. Tere was no evidence that a screw was impinging on any nerves. I was soon back on pain meds and my pain continued to get worse over time until I was unable to work. I have a lot of chronic pain now but before the surgery I could barely walk and was running the risk of serious further complications. My disk was desiccated and bulging into my spinal cord to the extent that the guy who did my MRI and my doctors PA both were surprised that I was able to walk without crutches or in a wheelchair. If it moved any further I would lose bladder and bowel control and probably would not walk. I could also kiss sex goodbye. So although I have problems down the road I'm sure I'm better off than if I had done nothing. In lumbar region he said age is a factor on your long term benefit. Younger people have more success overall.
Sorry my answer is so long but there are so many things to consider. I refused to have back surgery until he explained my future complications if I did not. A lot of people's stories sound bad but when you factor in these other risks of not having it it would be a shame to make your decision based on other peoples negative comments. You may have noticed that you don't see many people on here talking about their successful surgery. Probably because they have better things to do.
I hope any of this helped. If you have any other questions or concerns I don't mind helping any way I can. Good luck.
I've had 3 lumbar surgeries, 2 fusions and a smaller one in between the two fusions. I'd definitely have another if it meant pain would be lessened. But knock on wood, I am pretty much pain-free now...oh, I should add I had my first surgery at age 58 so you don't have to be younger to have good results.
But spine surgery really is a crap shoot in so many ways. First the patient is gambling on the fact that the surgeon she has selected is technically, and diagnostically brilliant. Then, that the surgeon has indeed figured out which surgery is appropriate for what he thinks is the pain generator...and that he is correct in his decision. More surgeries "fail" because the right thing was not operated on than fail because something went amiss with the surgery itself.
You do not indicate if you have had a recent lumbar MRI. It may be that just by virtue of being fused at L4-5, you have developed an "issue" at the next segment, L5-S1. This would not be at all surprising and it would cause similar issues to what you experienced with L4-L5.
My recent three level fusion was actually a lot less painful than the first fusion I had about 3 years previously. It was a much more complex surgery, involving some spinal reconstruction, and it seems to me, it should have been at least equal in discomfort to the first, but it wasn't. I was off all meds by the 12th day. Now recovery has been longer...but in part that is because I have been VERY conservative in when I start doing things, and everything I have done is designed around not causing a bit of flare to my sciatic nerves.
When you get your neck healed, you can deal with all this. In my opinion, it would definitely be worth checking out. At least then you'd know what you are dealing with and what you might have to face in order to better the situation.
Thank y'all both SO much for your information! When I talk to people that hasnt been thru any of this I feel like they just think I'm making a mountain out of a molehill. Lol actually I have a wonderful family that stands behind me 100'. I just hate when I have a surgery their all just waiting- can u tell any different, does it feel better-well the first time I had a Laminectomy , foramenotomy & the bulging disc that was herniated out. Never got any relief, actually seemed worse. So went to Houston , researched specialist & he said that facet joint had been rendered useless? What he showed me was when the other surgeon tried to make room for my nerves to go thru, the cut too much out & he said it was like a 3 legged chair, my spine would never be stable without a fusion. So I had spinal fusion at L4-5 & had high hopes. Got some relief but just never got back to a point where I was without pain for long. They said some of it was nerves damaged, bursitis in hip where they took out bone. Went through test , epidural shots , you name it. So anyway now that I've bird y'all to death, if this neck stuff all turns out ok, maybe I will think about asking if he can do the freezing test. Thanks for listening( whoevers listening) lol