Question: Can pedicle screws cause problems in the spine later on?
I had an L5-S1 lumbar fusion in with the pedicle screws and rods. My surgery was successful and now my x-rays show complete fusion. I play competitive sports (ultimate Frisbee, which involves diving on the ground to catch the disc) and have resumed full activity for the past few years. I'm now 34.
I pretty much can do anything, but have had a dull low back pain for the past 6 months, which I've recently felt in the sacrum. I also have some sciatica after running hard. I now want to get the hardware out.
My doctor thinks I'm doing well and shouldn't bother getting them out. I really don't want them in and worry that the rigidity of the metal will cause problems in other parts of the spine later in life. I've also heard stories of the screws breaking or causing problems in the bones, but I don’t think I've experienced that yet (I probably would know).
I don't hear many stories of young people getting their bolts out, so I don't know how common it is. Do you have any thoughts?
Doctor's response: Pedicle screws are unlikely to cause damage
It is not all that common to get the screws removed. At this far out from your surgery, they are not performing any structural function within your spine, so removing them is possible, but only about 50% of patients find it at all helpful for any ongoing lingering symptoms. The screws themselves are, however, not likely to cause any damage to the other tissues in the spine if you leave them in.
I am not all that aggressive about recommending hardware removal, but the one time it probably can be of help is in those patients where they are placed at L5-S1. This seems to be a level where the screws can cause some soft tissue irritation.
Sometimes if you have the area around the screws injected with Lidocaine, and the pain is relieved, this would give you more indication that removing the screws would be helpful.
In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.