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Help!, should i have my lumber metalwork removed?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:30 AM in Back Surgery and Neck Surgery
I have had various lots of spinal surgeries over the last 15 years........7 to be exact!

My last op in January 2008 was L5/S1 PLIF with decompression at L4/L5 with dynamic instrumentation at L3/L4. I recovered well 6 months post-op, infact i was overjoyed that this operation was going to be a success after years of pain and disability.
Then about 6months ago i developed a "new" type of pain. I have tingling in both legs at night, and chronic pain when i lie down.
Whereas before my op the only relief i got from my pain was to lie down!
I can walk up to 2 miles without pain but sitting and lying down is unbearable.
My surgeon has suggested removing the metalwork. The fusion is solid he says, he thinks it is possible that the metalwork is causing my problems.
However, i am concerned that my x-rays and scans show no evidence of any loose metalwork.
Has anyone else has their metalwork removed without evidence of looseness?
I am desperate to get rid of this awful pain but im concerned about having more surgery if it isnt going to solve my problem.
Any advice would be fantastic.


  • there have been a few members with reactions to the metal hardware in thier spines, so not as uncommon as you'd think. good luck.
  • I can't help you with that but I just wanted to welcome you to the forums. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • If you are fused, no reason for hardware. Hardware can cause lots of issues, even if a a break or loose piece does not show up on a film. Just FYI-hardware removal for me was a cakewalk compared to fusion surgery. Was just an overnight stay in hospital and was able to walk from OR gurney in my room to the bathroom straight after surgery(at my request.)
  • Hi, I had my hardware removed at 7 months post op, as mine was causing me ongoing pain. The removal surgery was a lot easier than the original fusion surgery and I was back at work within a couple of weeks. Click on the link in my signature to read more about my story.

    FYI, statistics I came across said that up to 15% of patients fused with hardware may undergo surgery at a later stage to have their hardware removed, but only in around 50% of those cases does removal of the hardware help reduce pain.

    Keep positive!


    ...an old timer here and ex-moderator

  • Greetings from Australia

    Agree with above comments that hardware isn't needed once fusion has 'taken'. I'm about to get my lumbar hardware removed, but only as an 'extra' while doing another surgery.

    I've had 3 spinal surgeries:
    2005: L2-L3-L4 decompression & fusion w/ BMP & instrumentation.
    2006: repeat L2-L3-L4 fusion w/ bone graft & instumentation replaced - BMP didn't take.
    2007: C3-T1 decompression & fusion w/ bone graft & instumentation.

    This year I've noticed a lot of loud 'clunking' around lumbar area - surgeon thinks it's the instumentation although all looks fine on X-Ray & MRI. Although the clunking isn't painful, it's annoying & sounds like it's not doing me any good. Has anyone else noticed loud 'clunking' after a fusion with instumentation? Mostly on flexion & straightening back up.

    Anyway, am now facing my 4th surgery, this time decompresion & fusion of L4-L5. I was told that there would be problems 'in the future' above & below the L2-L3-L4 fusion but this has only been 3 years! The doc said he'd remove the hardware from the previous L2-L3-L4 fusion at the same time as this L4-L5 surgery. Hope this stops the clunking.

    Has anyone else had to undergo surgery so soon below a previous fusion? This disc (L4-L5) was fine 3 years ago & now it's degenerated badly. (I do have DDD) I've always been fairly active, and have been keeping up Pilates & gentle Yoga all throughout these surgeries, including pre-hab & rehab.

    The pain is incredible from the L4-L5 nerve root compression. Epidural steroid injection was done under CT but hasn't really helped. I've had to start using a walking stick as the pain is worse when weight-bearing. I'm ok sitting down at work, but getting to & from work is a nightmare on public transport (no choice). The pain is in the left hip/glute area, radiating down to the outside the knee, plus the lower left leg, medial aspect, has gone numb. What surprises me most is the pain at night, trying to sleep. I'm not weight-bearing, yet I'm waking up 4-7 times per night. Have had to go on morphine plus valium at night just to try to get some sleep. If I'm ok sitting down at work, why is it so painful at night, lying down (I'm definitely not weight-bearing in bed).

    Am on so many meds it's crazy:
    Mobic 15 mg daily
    Norspan Patch (7 days)
    MS-Contin 30mg in morning
    Endone 5-10mg for breakthrough pain
    MS-Contin 100mg at night
    Valium 5mg at night
    Neurontin 400mg three times/day

    Just thought I'd join in the discussion.
  • Thanks everyone for youe comments.
    I think my main concern is im not sure if my new pain is down to the metalwork or not?
    I recently had a blood test which showed up i have rheumatoid arthritis. This ties in with my stiffness in the mornings. Could my pain be due to this? or the metalwork?
    Does anyone know if arthritis shows up on a scan or x-ray? My consultant hasnt mentioned any arthritis showing on the scans?
    Im so confused! I just want to get rid of this pain.
  • Tigerhev,

    Finally someone I can relate to!! I too have had two level fusion with dynamic stabilization at L3-4. I was doing good until 6 months post-op. Like you, I can not lay down too long before the pain insists that I get up, and I am very sleep deprived. But I also have pain/numbness standing, sitting, and walking. Less than one year post-op, I discovered the device had broke. One problem is the radiologists looking at the imaging have no idea what they're looking at. Even with new issues presenting themselves, my doctor seems perplexed by my complaints. He has not offered any plan for resolution.

    I have discovered company/FDA recalls for some dynamic stabilization devices and some screws: the devices and screws can loosen/break, and can cause other issues. These devices seemed mechanically logical, but some have needed tweeking before being approved for use. And when problems are presented, it's important that a doctor is ethical enough to plan a course of resolution to achieve/preserve function. Some of these devices and screws need to be removed. Which device do you have??

    I hope you doctor is an "ethical" experienced doctor who talks to you honestly and is determined to resolve the issues that present themselves. There has to be trust, or the doctor/patient relationship is no good.

    Me........I'm looking again.
  • Arthritis can be seen on CT scans, but if you've got hardware, it creates interference(artifact) with seeing all the details.
  • Hi Tino,
    Thanks for your reply. Ive no idea which metalwork i have.

    Has your doc not suggested removing yours?

    I feel like im trying to diagnose myself, ive lost all faith in doctors and surgeons. I feel my doctor is just "making things fit" because i dont think he knows whats wrong with me.
    Its so disappointing that i was so good after the op and now i feel in so much pain. Do you get a burning feeling when you lie down? I get it when i sit too. Ive just lost my job because i cant sit for any length of time. Im fine if i keep moving, my walking is much improved since the op.
    This makes me wonder if arthrits is the problem.

    I think i will go ahead and have the metalwork removed. At least if im no better, it will be ruled out.

  • Hi Tigerhev,

    I too was doing good post-op. My family and friends were amazed at the difference in me. Then, six months post-op there was a distinct change for the worst. My symptoms and conditions(as demonstrated on imaging) were progressively getting worse. And yes, I get the burning sensation, but it seems when the sharp pain and intense spasms are quiet. Occassionaly, my right side is completely numb(from hip to toes), and I'm unable to ambulate without crutches.

    Eight months post-op, my neuro recommended surgery to resolve some of the issues. When I went back to schedule surgery with new imaging in hand, my neuro stated I broke my device, but has not offered any plan for revision. Now my neuro seems perplexed by my symptoms and still has no plan to help me. On a hunch, I reviewed past imaging and found the device broke when I noticed the change.

    You should find out what's been put in you. It might help you understand what's going on(your symptoms), help you understand your doctor's decisions, and help you make more informed decisions about what to do. It seems your doctor is willing to try to stabilize your condition.

    Hang in there. It won't be long until these devices are better improved: remember how will you were doing post-op.

  • I also have had a great recovery - as far as the fusion part goes -


    I have a constant back ache that never seems to go away and seems to be getting worse and worse. It's like it's coming from the scar area, just barely to the side of the spine. It comes from both sides of the spine.

    My NS pushed on the area I showed him and my right leg (he pushed on the right side) just buckled right under me. He thinks it is the screws and that I also should consider getting them removed now that my fusion is fused.

    My sister (a massage therapist) described it to me in clearer terms - she put it rather succinctly: "So, the screw heads are just in there making hamburger of your back muscles"

    After that description I'm more inclined to agree with the NS about considering getting the hardware removed.

  • Hello,

    I had an L1 wedge fracture in Oct 08 which was stabilized with metalwork spanning T12-L2. I was recovering well but in the last 2-3 months I've been experiencing very sharp burning pain in the L5-S1 region and a lot of stiffness. My consultant has suggested removal of the metalwork but I concerned about post op recovery.
    Has anyone else experienced anything like this? It would be amazing to hear from people going through the same thing. x
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