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TLIF Pedicle Screw Placement and Surgery Process

KarlaCKKarlaC Posts: 6
edited 06/11/2012 - 8:40 AM in Back Surgery and Neck Surgery
This may sound silly to some, but I am looking for specific information about the TLIF surgery process after pedicle screw placement. I had a TLIF on 12/14 and am actually doing very well. However, the area around my pedicle screws sometimes is still a little sore. I asked my daughter to massage it, but she freaked out saying she could feel those bumps (the pedicle screws); and she was afraid to massage it because she thought that by massaging it she might perhaps be digging the screw into the muscle/tissue area around it; thereby making it worse. Surprisingly, it had not occurred to me before, but I got to thinking: I don't know what is around those screws that keeps the muscle from being irritated. I don't go back to my doctor until the 22nd, and I don't want to call & waste the doctor's time with just this question! I assume there is SOMETHING between the pedicle screws and muscle? One would think there would be a ton of info on the Internet about this; but TRUST ME - there ISN'T!! I spent a lot of time looking on websites and have not found the answer to this question!

Does anyone know? I am thinking the doctor put the bone graft material on the outside of the pedicle screws? My procedure consisted of restoring disc height for a collapsed disc and cage insertion; with rods/screws in L4/L5 at S1. My surgeon said he used 3 materials to restore the disc: part morselized cadavar bone, my own bone marrow, and protein called BMP. I assumed this combination was used for restoration of the disc. I found some doctors put bone graft material on the outside of the rods, but I don't recall if my doctor said he did that or not. I'll have to be sure to ask. Nevertheless, does anyone know if there is any material between the pedicle screw and the muscles?


  • I am not sure either,and you would think I would know,since i have had 2 spinal fusions.But trust me,someone on here will know! keep us posted!Jeannie
  • I had something similar happen to me as well...I had a 2 level fusion with hardware at L4-S1 on 11-16-09...I was having issues where it felt like a rubberband snap in the area where the hardware was and it was also somewhat sore. The doctor told me that this was normal, that the muscle is on top of the hardware and it will take time for the muscles to get used the hardware being there. He said it is perfectly normal to feel the rubber band snapping sensations and some tenderness and that eventually it would go away. Hope this info helps you, best of luck in your recovery.
  • Hi Karla,

    See if this helps answer your questions:



    I'm of the opinion since fusion is such an extensive/invasive procedure it isn't a bad idea to have your own copies of this part of your medical history. I have my xray, MRI & CT scans on CD along w/ radiologist assetments of the films, my OSS office visit notes as well as full hospital record. I didn't need cadarver or BMP since there was enough bone from the lammies, bone spurs, facetomies, etc. OR notes state autograft was placed w/in L5-S1 space packed left & right intranuclear zone. Permanent PEEK Capstone cage w/ autograft placed. Large amounts of autograft placed w/in facet joint/lamina areas. Small amounts autograft placed lateral to screws and gutter. My OSS used Medtronics Sextant System for my surgery.

  • Wow! Thanks all for the comments and the links to the articles. I had found similar articles and animations, but not those specifically in the links above. They were both very helpful! I have a list of questions for my doctor and this information helps me prepare for that as well. :-)
  • I need to check out those links!

    Just wanted to mention first that the catching sensation is a main reason that I had a hardware removal.

    I had a PLIF with screws, rods and PEEK cages with cadaver bone and BMP packed in it. This were placed around the spine- around the screws to promote fusion.

    At first (at about 6 mo. post-op) I could push or accidentally hit what felt like a screw head and I would get a zinger pain down my leg on that side and it would buckle under me. It was a very strange sensation, almost a lack of sensation but it was like one of those old standing puppet toys, you push the button and the whole thing collapses down. That was me - push my button and my leg would collapse.

    My PT used to do grissage(sp?) scar reduction work on my back. My scar itself was numb, so I didn't feel anything when he did it.

    Then later, as it got worse, I would be walking and suddenly a muscle in my back would feel like it caught on something and I would not be able to move my leg until it released. It was pain that prevent movement. I almost constantly had a backache from these episodes.

    When I had my hardware removal the NS mentioned that he had to scrape away some bone to get to all of them. So, yes, eventually the bone can cover the screw heads too.

  • Glad it helped, have a great weekend all

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