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    Old 02-19-2013, 09:10 AM   #1
    in pain man
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    Question lumbar fusion hardware removal

    New to the site and hoping i can find some help.
    I was a police officer for 10 years and ended up disabled within in 2 year period. I was in a fight that fractured a vertebrae in my neck, separated my shoulder and significant damage to L5 disk. I dealt with the pain from '03 to '06 when my neuro told me i had severe damage to my sciatic nerve. Dove into fusion in '06 at L5-S1.surg went well and recouped well.
    was back to work no restrictions as a patrolman -in 4 months and was promoted to Investigator 1 year later. I began to notice that as i was walking i was tripping on my own feet. was shortly diagnosed w foot drop. after several Dr visits, they all agreed i could not work in that condition as LEO. between '07 and '08 my pain increased and found it very hard to sit for any length of time and standing or walking was excruciating. several drs later, they agreed disability was my only option. so bit the bullet and 2 years later, the state deemed me disabled.
    In march '11 pain was so bad i had a laminectomy at L4, pain went away and was feeling better, thinking of going back to work. in December '11 pain came back, new surgeon visit and in 10 seconds of looking at my images said " i know your in severe pain" he showed me yet another clasped disk at L4. So fusion at L4-L5 in Aug '12. had a complication of a tear in my cerebral spinal cord due to all the scar tissue. it was torn when the dr tried to remove some to get to the disk. hospital stay was 16 days. I recovered well and went home. Had in home physical therapy and after that i was well once again. i was able to walk. Went bow hunting on my own no pain other than the incisions etc. and in Nov "12 that old familiar twinge in my low back.
    I went from being active again to bed-recliner every day w major pain in just 3 months. Cant stand, sit or lay in any position more than 30 min or so. back to dr test after test after test, more pain blocks- none helping. finally had injections yesterday 2-18-13 to test for hardware pain. and today i am walking sitting bending without much pain. so now i am looking at removal of hardware L4-S1. has anyone had there hardware removed? whats the surgery like compared to fusion itself? recovery time and does it eliminate any pain? is it worth another surgery?
    I know this is a long statement but had to get it all in there.
    thanks for any help

     
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    Old 02-19-2013, 10:29 AM   #2
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    Re: lumbar fusion hardware removal

    Welcome to the board.

    I had hardware removed, but then more was put in...so can't answer your question from personal experience. However, friends that have had it done report that it is much easier -- recovery is faster and if it was the hardware causing problems, it should help with the pain.

    Do they know that you have a solid fusion? Sometimes hardware is blamed when in reality the bone has not grown to make a solid fusion and there still is instability.

    If you've had all the tests the surgeon recommends and he feels the hardware is the problem, you might as well give it a try.

     
    Old 02-19-2013, 10:34 AM   #3
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    Re: lumbar fusion hardware removal

    thanks for responding.
    yes, he says all bone has fused. he wanted to do an extra test if this did not work. dont know the name of it but he wanted to inject my L3 disk with imaging to see if it has a hairline crack that did not show on other images. so far since yesterday my pain is significant better and i just rode 8 miles on my exercise bike w o pain. so i believe the pain is coming from hardware.

     
    Old 02-19-2013, 10:36 AM   #4
    in pain man
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    Re: lumbar fusion hardware removal

    thanks for responding.
    yes, he says all bone has fused. he wanted to do an extra test if this did not work. dont know the name of it but he wanted to inject my L3 disk with imaging to see if it has a hairline crack that did not show on other images. so far since yesterday my pain is significant better and i just rode 8 miles on my exercise bike w o pain. so i believe the pain is coming from hardware.

     
    Old 02-19-2013, 10:52 AM   #5
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    Re: lumbar fusion hardware removal

    I know a bone scan is supposed to be the best way to determine what is going on. I've not had one so can't say if what's what your doctor is planning for you.

     
    Old 02-23-2013, 09:00 AM   #6
    in pain man
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    Re: lumbar fusion hardware removal

    the injections around my hardware worked. i had 90% less pain for about 3 days then the meds wore off and pain returned. i have an appointment w the surgeon to discuss removing my hardware-

     
    Old 02-23-2013, 09:23 AM   #7
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    Re: lumbar fusion hardware removal

    Hi. I had several surgeries to my spine. In the cervical region I had Harrington Rods placed from C3 to T5 level and in the lumbar from L2 down to the hip area.

    After that I had a spinal cord stimulator implanted in the lumbar region. But still had issues with the cervicaL spine and thought of implanting the spinal cord stimulator in the cervical area. But since there were Harrington Rods already there there was vey little room to implant the stimulator. The question came up about removing the hardware.

    But both my neurosurgeon and my pain management doctor/anesthesiologist both stated that it was extremely risky to removed hardware from the spine. They indicated that there was a risk of paralysis.

    I know you are asking about the lumbar area and I was faced with hardware removal in the cervical spine so not sure why or if one can be done and if one is more risky then the other. But my understanding of hardware removal was that the risks were too high to attempt it.

    I have heard of others post about hardware removal so I am not sure of what the risks are. But for me at least I was steered away from it because of the risk factors.

    I wish you well. Sounds like you have been thru a lot as most of us that post here we have faced challenges as well.

    Please keep us posted on what you do and how you make out.

     
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    Old 02-23-2013, 09:28 AM   #8
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    Re: lumbar fusion hardware removal

    thanks for the reply. i understand completely where your coming from.
    if i wasn't is pain 20 hours out of the day i wouldn't consider it. but at this point i am home bound. no activity at all. i go from the bed to chair to bed taking pain meds in between. if i could be somewhat active, that is if i could go out side w my daughter and go out to eat, cut down on meds etc, i wouldn't do it. but as i am now i think that is my only chance to get some relief.

     
    Old 02-23-2013, 09:43 AM   #9
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    Re: lumbar fusion hardware removal

    In Pain:

    I certainly understand everything you are saying and feeling. I have been having spine issues since 1988.
    In the beginning I was ok in that I had surgery and went back to work. But every time I turned around it was another NEW issue and another surgery.

    I have been on SSDI / disability for 10 years now.

    Some days are better then others in that I can get around and do things and most people that look at me initially wouldn't know anything is wrong.
    But then there are days that I am screaming in pain inside.

    Since the Spinal Cord Stimulator implanted in my lumbar region, it has been remvoed in that it wasn't working.

    This year I went for the Intrathecal Pain Pump implanted in the mid back to help the mid-low back area. I would say I have found great relief from it in the month that its been in. Yes there are days that I may be more pain in that area but not as severe.

    But I am not dealing with Neck issues . the pump doesnt help the neck area.We went for the area that was the worst. My neck I am at the point that I get at times radiating pain to the arms; weakness in the arms and hand area. For this I am taking oxycodone and a muscle relaxant. Sometimes it helps better than others for the pain. I find driving difficult since my neck acts up especially while driving. So I am limited on distance that I drive too.
    I was told that the doctors are afraid to touch my neck because of the latest diagnosis. Plus if they did surgery it would be extremely risky a nightmare as per my surgeon. And some of the issues in my neck theres not much they can do for me surgically anyway.

    an EMG showed severe nerve damage in the neck and low back severe arthritis and peripheral neuropathy. The neuropathy partially stemming from the spine and some from my diabetes.

    My surgical risks beyond the diabetes is that I am in kidney failure and the surgeon is afraid to touch me because that adds to the risk of surgery.

    I will close feel free to post more for support. Good luck

     
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    Old 02-23-2013, 07:29 PM   #10
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    Re: lumbar fusion hardware removal

    I'm not commenting on any removal other than for the lumbar area, but hardware removal is not any more risky than any other lumbar surgery. There is next to no risk for paralysis as the spinal cord has ended at the L1 level, so there isn't any risk of damaging the spinal cord.... It's usually a matter of removing the rods and pedicle screws. If a cage was used to replace the disc, I believe it is left in as the bone has grown around and through it. It's made of a high tech plastic anyway, so there isn't a worry about an allergy to it or of the body rejecting it as there might be with the metal.

    I know a number of people who have had hardware removed, including myself. If no other surgery is done at the same time, it isn't that big a deal. People are in the hospital overnight and then just have to recover from the surgical wound...not from surgery on the spine itself.

    If your fusion is complete, as the doctor believes, you shouldn't have need for any new hardware...so it should just be a matter of recovering from the anesthegia and letting the incision heal.

    (It is very dangerous to have an artificial disc removed. Perhaps that's what others were remembering....)

    Last edited by teteri66; 02-23-2013 at 07:31 PM.

     
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    Old 02-26-2013, 05:10 PM   #11
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    Re: lumbar fusion hardware removal

    [QUOTE=in pain man;5137123]the injections around my hardware worked. i had 90% less pain for about 3 days then the meds wore off and pain returned. i have an appointment w the surgeon to discuss removing my hardware-[/QUOTE]

    I think injections are a waste of my time and probably your time when you think of the big picture. Really... the relief, if any is so short lived in most people - I'm done with them. I totally understand your pain levels and your desire or drive to go back to work. You enjoy serving in law enforcement and that's commendable.

    I have the same desire as I work in national defense and I suffer in pain every single day, sometimes it is just so overwhelming. Today, fellow workers looked at me strangely when I let out a yelp from a huge back pain surge, that hurt so bad, but I wasn't willing to quit yet.

    I have never considered hardware removal, but they have discovered through a CT scan that bone spurs have grown in that MRI cannot see because it is blinded from the metal - yet the CT scan found them underneath the fusion area impinging on the L-3 nerve root.

     
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    Old 02-26-2013, 06:17 PM   #12
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    Re: lumbar fusion hardware removal

    in my case the dr was using the hardware injections for diagnostic purpose- not for long term relief. he even told me when we talked about it that if i had relief it probably wouldn't last about 8 hrs or so.
    so a few days was welcomed. if the hardware is the problem then i want it out. don't want another surgery but i also dont want to be in pain 24 7..

     
    Old 11-02-2013, 06:15 AM   #13
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    Re: lumbar fusion hardware removal

    Hi,
    IN PAIN MAN: Your post sounds very similar to my husband's situation.
    Thanks!

    Last edited by moderator2; 11-02-2013 at 06:41 AM.

     
    Old 11-02-2013, 07:14 AM   #14
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    Re: lumbar fusion hardware removal

    So sorry to hear about all your suffering.

    I know a couple people with some extensive hardware holding their lower backs together and from the pictures that I've seen I just cannot image their being able to cope with having it removed.

    Remember, the original surgeries removed a LOT of bone and disc support material and the titanium/steel/rods/plates/screws were put in to compensate. Often it is only the hardware holding things together. You cannot reinstall the discs.
    (Well, maybe in Europe)

    My guess is that with most hardware removal there is new hardware put in.

    Last edited by Voxx976; 11-08-2013 at 08:50 AM.

     
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