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Hardware Removal - Why?

AnonymousUserAAnonymousUser Posts: 49,731
edited 06/11/2012 - 8:24 AM in Back Surgery and Neck Surgery
First, let me say that this is a fantastic site with tons of information. After reading many many posts, I think the best part of the whole place is the compassion and support of and by the many users. THANKS for the wonderful source of support and information!!!

I've been a visitor here lurking for several weeks but post very rarely...

Now my question. I'm sure it's a case of misunderstanding on my part, but why would someone have their hardware removed after a fusion procedure? Is this only done in the case of failed procedures where the screws/plates/rods are causing problems? I had a TLIF done in Sept '07 which the bone graph failed and never started to fuse (having a 360 in Nov) and the only time the surgeon mentioned removing the hardware from the TLIF was during the PLIF portion of my upcoming 360 procedure.

Thanks again,

Kevin
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Comments

  • hi Kevin, and welcome to Spine Health. As far as hardware removal, they only do it if it creates some problems, like an infection develops and they suspect that the hardware was contaminated, or there is problem with the placement, e.g., screws press on a nerve, etc. Even then, I think it is usually done after fusion is complete. But it is only a small % of ppl who have it done. If there is no problem, you keep it forever.

    Kin
  • Hi Kevin, glad you have come out of lurkdom to post ;). Once the bone is fused there is no need for the hardware. Since removing it requires major surgery, they leave it in. On occassion some people have pain caused by the hardware. They can confirm this by injecting near the hardware and seeing if it gives relief. So if the hardware is causing pain they can remove it. Several members have had this done and even keep their hardware as a souvinere. My surgeon says he only removes it in 1% of cases, but I read it can be 15-20%. See ya round the boards, Cali-Sue
  • The hardware is only required to hold the vertebral joint(s) solid while the bone graft fuses (1-2 years for full 100% fusion to take place) and thereafter it is not necessary, however it is not normally removed as it obviously entails surgery to remove (usually major surgery although sometimes hardware can be removed by minimally invasive techniques).

    Apparently up to 10%-15% (or 15%-20% depending on which reports you read) of fusion patients end up with ongoing pain and end up having their hardware removed in an effort to remove that pain. There can be several reasons why the hardware can be causing pain, such as a broken pedicle screw, misplaced screw, etc.

    I had ongoing pain after my L5-S1 fusion, that was attributable to a misplaced pedicle screw and had my hardware removed at only 7 months post fusion surgery.
    Keep positive!

    Bruce

    ...an old timer here and ex-moderator

  • edited 06/19/2014 - 2:12 PM
    Hardware set to be removed. Dr Agreed it was necessary!
    JD
  • KeishaKKeisha Posts: 4
    edited 04/21/2014 - 1:37 AM
    I had a fusion on my T7 after compacting it, then rods and screws from T4-10 in August 2013. The bottom screws have been more prominent and giving me some pain since the scar healed. I had a 6 month check up with a different doctor than to the one who did the surgeon. The new doctor said he would be happy to remove the bottom two screws because they are causing me problems. The vertebrae hadn't regained any size, so he couldn't remove all the hardware and he said rarely is it all removed. I'm currently on a waiting list to have the surgery because it elective and not urgent.
  • Hi Kevin. I'm a newbie and a lurker too. :) I had an L5-S1 back fusion done in Nov 2008. I suffered a nerve injury that resulted in a drop foot and it took me 2 years to learn to walk again. A post-op x-ray showed that although the bone graft had taken, the cage had moved from between the vertebrae to out the side slightly which unfortunately means it cant be operated on without causing more nerve problems so I just hope for the best that it doesn't move any more! I am one who had the hardware removed 3 years after the fusion. I did this for a number of reasons. One of the screws was sitting very close to the abnormally positioned cage and my surgeon was concerned that eventually it would push on the cage and also, because of the stress/pain associated with the nerve injury, I lost a hell of a lot of weight.and no longer had much cushioning over the hardware which made driving and sitting or any type of pressure on the skin above the hardware extremely painful. It was the best decision I have made. Although I still have ongoing pain issues from the nerve injury, the horrible searing stingy pain from the hardware rubbing on my skin from the inside has gone! :)) I live in NZ so my surgery was covered by ACC (Accident Compensation Corporation) as it is regarded as a treatment injury. ACC takes away our ability to sue the surgeon (damn it all!!) but it does give us access to home help etc which from reading the forums here is not something you can readily get there in USA? Anywhoo......just thought I would share my experience so you understand why some people may choose to have the hardware removed. Regards, Amanda :)
  • TDawgTTDawg Posts: 33
    edited 03/02/2015 - 7:28 PM
    Imterestimg andatbe being aaecatic, but if not, have your MRI and wait for.them to.put it.on a CD ROM for you. There are.many places that will.give you this at no cost. (Except.for.the MRI cost) And go.to a different facility and probably a new Neurosurgeon unless you like.the one who did.your last surgery.
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