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Pain caused by hardware

kd1261kkd1261 Posts: 2
edited 06/11/2012 - 8:43 AM in Back Surgery and Neck Surgery
Had a fusion in 2008, L5 S1 location. Since then the pain is worse than before surgery. Pain is always on left side going towards middle of lower back, where the hardware was entered. This may seem funny, but I feel like something grabbing my spine. I have had every test under the sun done to see if screws or cage have slipped or broke, but all tests come back fine. Also have had 4 injections, nothing has worked. I really question the hardware. Is it possible that even if the hardware in my back is ok, can hardware create pain just by being in the back? Has anyone had a hardware injection? My pain doctor won't do it because it's too risky with complications


  • I had a huge fusion too - from just below my shoulders to my tailbone - I have the titanium rods & I have 24 screws - I constantly feel like I am wearing a brace - under my skin - do you know what I mean? I feel heavy sometimes & I swear I sometimes can "feel the hardware". I go to my surgeon every 3 months & every time the hardware is all in place on the xrays & they check & monitor me carefully. It's just a constant sensation & especially if I'm tired or have overdone it - which doesn't take much - I just feel that heavy hardware sensation.

    I walk every day & I go to a water class twice a week for 45 minutes so it's not that I am just
    not trying to do what I can - it's just like you described - I am being to wonder if it will be
    permanent. My surgery was 15 months ago.

    So yes, I know exactly what you mean.
  • I am curious what kind of tests you have had to check the screws, and hardware if you have not had a "hardware injection?"

    Overall, up to 5% of fusion patients end up having their hardware removed, usually after they have fused. While it is not common, some people are not tolerant of the materials in the hardware. But usually that causes a more generalized problem such as swelling.

    When there is a localized "poke" or something similar, it is more likely a hardware failure of some sort...broken screw, slipped rod, etc. If your doctor is looking at a MRI or X-ray to determine the position and condition of the hardware, he may not be able to really see exactly what is going on. I've noticed from personal experience that you can show three doctors the same images, and you can get three opinions on whether or not there is a loose screw. It is not a clear-cut call, apparently!!
  • KD, you said it correctly: hardware can cause pain simply by being in there, even if nothing is amiss.
    That's what 2 NS' have told me, along w/ my PT + my primary doctor. I also had my PLIF in 2008 & have not had one minute w/o hardware pain since then.

    Mine feels like a "banana clip" (like people used to use for holding hair in place) in there all the time--just a tight, grabbing sensation, as you say. Somedays are really painful, other days it's just annoying, but I am ALWAYS aware of it. Mine is also localized in my lower left back, like yours, & I'm schdeuled for a CT & MRI in June to see if there's a problem w/ that screw placement, as my new NS suspects.

    Not that I want to do much about it---! Removing my metal would mean a 4th procedure & with my history of dural leaks, scar tissue & infections I think I'll just continue to take my meds & "live with it" as both NS' suggested at this time. I also have a lot of nerve damage in both legs, which is getting worse, & both docs think this too stems from hardware issues.

    But the fusion is "perfect"---! Go figure!~

    As many have said b4 (me included) fusion surgery often solves some problems but creates others. Personally, I beleive I traded my basic problems for a host of others, now.

    I too had no luck w/ injections (did have a hardware block--felt no pain for about 2 hrs, then it was back to reality) & for now, I'm just going on with my life, working, doing what I can & not dwelling on what I can't do anymore---and trying to ignore the banana clip that did its job & is now just "in there" & keeps me humble! :)

    Better days ahead to you-- I feel your pain, I truly do!

  • My surgeon thought the same thing. That it was the hardware causing alot of the pain I had over a year after my fusion. He said pain from the hardware usually occurs because of small movement of the hardware itself. He informed me that any movement of the screws inside the bone, no matter how miniscule, can cause alot of pain for some ppl.
    They can usually tell if your hardware has movement by looking at the mri and seeing if there's any dark areas between the bone and the screws. If so, then that means theres room for the screws to move.
    He too talked about injecting the 'hardware' to see if that would tell me whether or not thats what it was however, after talking to my PM doc, he said it wasn't that good of a test to go by as they dont actually inject the hardware itself, they inject the tissue around the hardware to numb it and see if the pain stops. He said in doing so, it's not always accurate as injecting into that area alone is hard to do and it usually covers more then the area theyre trying to numb. It made sense.
    In my case, since they seen that my screws had room to move a small bit and since I had only fused on one side they decided to go in and look around. He told me if my back held good enough they would just remove the hardware and hopefully that would reduce my pain. When I woke up I found out that my back wasnt solid enough and I had a bone shelf that had grown into my spinal canal and that they had removed my hardware only to put larger hardware back in so I'm still no better off.

    I hope this helps you a bit.

    Good luck to you in your journey.

  • This past Dec, I had my hardware removed from my l4l5 fusion and i am glad it was removed. I was going in for surgery anyway for lami and i asked the dr is it posible that the hardware is the cause of more pain in back of my legs. so we did the hardware block and it did feel much beter after the hardware block. Removing the hardware helped the pain and stiffness in the back of the legs some what, but did not resolve the nerve pain i already got from previous surgery of artificial disc replacement before my fusion at same level.
    Flexicore ADR 2004 resulting nerve damage l4l5 Fusion 2006 same level, 2009 hardware removal with lami !
    2012 scs implant ,
  • I'm so with you KD. I don't want to HIJACK your thread. I basically have the same question so this is an interesting Thread. I've been begging my husband to just get the screwdriver or drill and take my hardware out for forever. He says he's not qualifed. (I often ask him if he might just need to stay at a Holiday Inn for a few days.)

    My poor choice of humor means I can't get the doctors to take me seriously. I've complained and complained about my hardware. Yet they say it looks great in all the images and no one will even entertain the idea of removing it.

    I swear it exist now just to make me miserable!

    So if hardware can cause pain how do you get them to listen to you and take you seriously? Mine feels like a swarm of bees sometimes or someone is taking a knife and cutting. Sometimes it's certain small movements sometimes for no apparent reason always in the same spot. Just to the side of the incision. GRRRRRR.........
    They will listen to all my complaints about pain, leg pains, etc. and then totally dismiss that one.
  • i know my hardware hurts me my dr said it slipped.i did post about in the recovery form.dr up my meds for now.very interesting post.
  • I think my hardware is bothering me as well. When I lie completely flat on my back, it feels like I'm lying on rocks. It is particularly bad at night, and I feel really good when I wake up and still in bed. I can move around and lie on my side without pain. As the day goes on...the pain worsens. I also feel it on my daily walks. I think it is a combination of muscle spasms and the hardware that causes me to stop walking at a certain point. Walking was my favorite form of exercise before the surgery. Two years ago( before the back issues), I was walking 25 miles a week...and was in heaven!!! You can solve all the problems in the world while walking. I can not wait till I'm able to walk 3 miles without the pain. What a blessing that will be :-)

  • HI,
    I had a L5-S1 PLIF in Oct 08 which helped greatly. After about three months I started having increasing LBP and muscle spams on the right side only. The docs took more MRI's, CT scans and myelogram. Everything checked OK by the tests but on right side I could put my fingers directly on the screw heads. I even ended up in the emergency room after bending over to dry my feet after a shower. It felt as if something had torn loose, I crawled to the van so my wife could take my there. I had many hardware injections to no avail. I wore my neurosurgeon out until he agreed to remove the hardware in Jan 2010. My pain levels in my back went from 7-8 to 2 in a month. Best thing I ever did. The recovery was longer than I thought but worth the price of admission.
    Hope this helps.
    God Bless,
  • Thanks Highwayman,
    That does help prove the "theory" that it can cause problems even though it looks wonderful in all the images.

    I like the way you said you wore your surgeon down. I may have to start really "wearing thin" on some doctor's nerves. LOL!
  • While I was at PT, while a lot of my pain was helped by the therapy, I told my PT that I had this one spot on my lower left back side that seemed to hurt a lot and the pain radiated out from there.

    She said that it was probably my hardware causing the pain and that it might have to come out, but they won't even think about that for another year. (BTY, I'm lucky that my PT is in my spine clinic so they can look at my xrays and MRIs at any time.)

    Anyway, I'm just going to live with it along with my C6/7 incomplete fusion until either of these things cause me to not be able to live a decent life any more.

    I wonder if (or why) lumbar hardware seems to cause more problems than cervical hardware? Maybe that's just my imagination and that's not really the case.

  • its been almost three years since my lumbar surgery and i was fortunate enough to have been given experimental flex rods to increase my mobility. the surgery has been a great success, but for the first 2 years i would feel the hardware in my back, or atleast though i could. it was especially bad in cold weather. i can say atleast in my personal experience that the feelings decreased over time. as of now i dont even know its there anymore. i think its kinda like going to the dentist. after the tooth is removed for weeks you are constantly checking that site with your tongue. until your mouth gets used to the feeling then its perfectly normal. i just think the body takes alot longer to accept the foreign objects within.
  • at 6 months out. The Axial bolt inside my spine at L5-S1 not so much really anymore. First few months yes. Deep ache in my bones.

    Now the rods and screws. Oh yeah. In fact the lower 2 are really easy to push on the top. I feel the muscles around them too. They still give me muscle spasms. Especially when I first lay down. It's painful getting up and I need to stretch. Then once I'm moving, not so bad.

    I asked my surgeon and he told me it was probably the one issue that I would be better off if I was "more meaty" as he put it... ;-) He also told me pain or not they say put until my 1 year visit. Then we will do Xray and CT Scan. If it is still a real problem then we can discuss removing the rods and screws.

  • I have had 2 failed fusions at L5-S1 and have a lot of pain, all mri's and ct milogram's all showed nothing, then I had a bone scan and they found the hardware was loose. My surgeon want's to use a bone growth stimulator, but this has been going on for 3 years, and the fusion never fused. Has anyone had success with this?
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