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Is the hardware removed in most lumbar fusions????

sagehenssagehen Posts: 221
edited 06/11/2012 - 8:22 AM in Back Surgery and Neck Surgery
I've seen alot of posts regarding hardware removal,my surgeon has never mentioned anything about it, and I guess I never thought about it. I've had 2 cervical fusions and the hardware from the first one was removed when they did the 2nd one. At this point, 4 months post 2 level alif, I can't imagine going through that! Unless there's harware failure etc...I should have asked so many more questions before I did this one!
Thanks and appreciate any insight.
Sagehen :??
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Comments

  • My NS said he only has to remove hardware in 1% of his cases, if it is causing a problem. Sue
  • My NS said it was about 10-20%. I think I feel my hardware some times (like right now) :''( .

    Julie
  • ....that the figure was around 20%.
  • my fusion was july 9. I then got the MRSA & all that drama. my NS said I would most likely want my hardward out since I am "so small"... I assumed he meant I'd feel it. then after the infection, he said my infectious disease specialist might want it out since bacteria like foreign objects such as metal. uugh. I was thinking the only way I'd want it out was if it was causing me SEVERE pain as I have no desire to EVER go through another surgery. I hope to God so badly I never need it out. but I guess only time will tell and I try to not think about it too much now, as I'm finally getting better and seeing the light at the end of the tunnel.

    my NS did say the hardware removal surgery is much less invasive then the actual fusion. I believe him somewhat, but please tell me he's not just trying to get me used to the idea? those of you who've had hardware out-- what was recovery like???
  • Firstly, hardware should only be removed if there is a need to remove it, i.e. if it is causing ongoing pain, or if the patient is suffering ongoing pain and the doctor feels that there is a good chance that it is being caused by the hardware. Another reason would be if your body is rejecting the hardware.

    Figures I have seen indicate that up to 15% or so of fusion patients may end up having surgery to remove their hardware, so depending on which surgeon you talk to, figures between 10% - 20% would be in the ball park.

    Sometimes the hardware can be removed by minimally invasive surgery and the patient is home again the same day - some members here have had this (I think that L-Dogg just recently had his hardware removed under day surgery). However for the majority of us (including my case) major surgery involving an incision the same size as the original incision is made to remove the hardware. I understand that the reason why many surgeons will still remove the hardware this way is that it gives them the opportunity to explore the fusion site and surrounding area for any other problems and potential pain-causing issues like scar tissue, spurs, etc., and, therefore, also the opportunity to rectify such problems if they find any.

    Recovery from minimally invasive hardware removal will be very quick. Recovery from open incision hardware removal surgery will be quite a bit longer, but should be much less than for the original fusion surgery. In my case, after my hardware removal surgery I was back at work (desk job) after two weeks and also restarted PT rehab at 2 weeks too. 3 months later I was able to climb/trek up a 14,000 mountain.

    Hope this helps!
    Bruce
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • I thought I was doing wonderfully well ...until about a month ago...I tripped in a hole and did a bad endo in my back yard. Then I drove a couple thousand miles for a wedding, toughing it out, but still didn't think I was doing too bad....but you know....I hurt like a son of a gun!And I swear I can feel the hardware...all the time. It's a sickening kind of ache...if that makes sense. I have had continual low back pain since my surgery, and hip pain (my Dr says it's bursitis) that could stop a freight train. I did finally get my nurse prac. to give me my pain meds without an inquisition, but they just make life tolerable.
    It's like a section of my back is pinched really tight...
    I don't know....but my leg pain when driving is gone...I told my Dr. if I got %50 relief I'd be happy, but I think I lied! Thanks for the info everyone!
    Sagehen
  • Hey Bruce,
    Don't mean to be redundant...but would x-rays tell? With my Dr. I will need to request any action...I'm not scheduled for any more follow-up until January....but have made an appointment for this month,because I hurt so much. I'd like to know if I'm starting to fuse yet, at least. And I plan to ask for a refferal to a pain management Dr. I don't know, I'm kind of flying blind.
    Thanks again
    Sagehen
  • I have follow up with xrays on the 25th of this month. My right side feeld great/normal/strong.... My left side feels as if every step I take is being pinched. It may be simply angry nerves- but the pain feels like nerve and muscle pain. I am very curious- maybe it is just a ligamentt that got cut?

    Right after my surgery the pain was terrible and it is alot better- but weird that one side is great and one side hurts if I walk/move.

    Julie
  • Yes, often plain x-rays can indicate a hardware problem. Also the doctor can inject around the screws in order isolate the source of pain to a particular screw.

    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • Julie, I am wondering if your left sided symptoms are related to the entry method your surgeon used. I had PLIF (POLAR) but it was approached from the left side,that is the laminectomy was only done on the left side in order to gain access to the disc space. So more trauma was done on the left even though both sides were accessed for the instrumentation. My radiculopathy was left sided, so that is why he chose a left sides approach. I too have more pain on the left, including tightness, SI pain, and hip pain. Just a thought, Sue
  • Julie did your surgeon use your own bone for the graft and if so was it harvested from your left side iliac crest? ......and if so, could the pain be coming from this area? Acute pain from the bone harvest area is quite common after fusion surgery.

    ...just a thought
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • I spoke with the NS nurse yesterday and they called me in this morning for xrays- I got a copy on cd but have no idea what I am looking at. The screws look okay to me- the rods are questionable. L5/S1 looks milky throughout and L4/L5 looks only 25% milky.

    Sue- I had bilateral everything- my scar runs down the center of my low back. But I haven't seen my NS since I left the hospital.

    Bruce- No- he used the bone that he removed from my spine and mixed it with BMP- he used a "sugar wafer" cage that is supposed to be absorbed within a year.

    I took 1000 mg of Tylenol last night and again at 5 am. I spoke with the pharmacist today and he told me I can take up to 4000 mg (subtract the mgs from the Norco and that gives me 2700). I think it helped a little because I woke up at 9:30 feeling better.

    I think I am expecting to much to soon :''( I just need to slow down and rest more with shorter walks. I keep reading about people walking 2 miles- 5 miles etc and I can't expect to do the same yet.

    I will let you know when I hear from the NS.

    Julie







  • I had the screw injections that diagnosed, as best as they they could tell, that my hardware was the culprit.

    I went in for Surgery on Thursday at 6AM...did paperwork and they hooked me up for the IV and I got changed etc etc...I think I went under around 8AM and woke up at some point, went in and out of sleep and basically at 11:30 i was walking around the room asking the guy if I could get dressed. he said yes, I called my wife and we left at 1:30PM.

    I went home and putzed around and for Friday through Monday had normal days....mostly up and about helping around the house for the long weekend...tidying, cooking, playing with the kids, playing music in my studio etc......and I napped here and there.


    On Tuesday I went to work and everyday has been a huge day for us and I have climbed around on lifts and stuff doing rigging ..the only thing I am avoiding is heavy lifting and extreme bending and twisting etc.... basically as soon as I start feeling pressure or pulling on my incision I back off. I am working hard trying to be smart about it.

    My incision is the same as the old one....about a 4-5 inch cut.

    I take 1/2 a Percocet twice a day at work and take a full one at night.

    Really in my case it has been totally handleable. A bit of pain, discomfort or aggravation here and there but NOTHING AT ALL like my initial surgery.

    I think you can believe your surgeon when he/she says it will be a much easier surgery than the first one.
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