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Hardware removal after ACDF

kumquatkkumquat Posts: 4
edited 06/11/2012 - 8:47 AM in Back Surgery and Neck Surgery
Is the hardware used for a cervical fusion always removed? Or only if there are problems with it??
I keep reading about hardware removals and just was wondering if this was normal?
I will be scheduling a fusion this week and am trying to get all my research done before I say for sure I want to do it.


  • Kumquat,

    Typically they only remove the hardware if there is a problem. I’ve had a 3” plate and six screws affixed to my neck for the last year and a half and they have not been a problem. No reason to open you up a second time, unless the hardware breaks or causes pain. What levels are you having done? Good luck!

  • Welcome to Spine-Health. Like Chris said, the hardware is intended to become a part of your body. I've had my cervical plate and 8 screws in place for almost two years with no problems. I even recently had a CT scan to check on it and it's still perfect.

    Do you have any other things we can help you with? You'll find a lot of great information with articles and videos on this site, and the members of the forum are more than willing to share experiences and offer support.

    Take care,
  • Chris, I'm having c5,c6 fused. I actually had an ADR that migrated, so it's a revision.
  • Bummer on the revision. I really wanted to do ADR for my neck, but since I needed 2 levels done it was a no go. Sorry to bombard you with questions but what kind of disc is it, Prestige, ProDisc? Is your surgeon going to leave it in and fuse from the back or are they going to take it out?

    Assuming your surgery goes well, I can tell you that I have noticed very little, if any, range of motion loss from fusion. Good luck!

  • My Dr. is going to remove the plate, I am having many problems with it. Unable to swallow without gulping repeatedly, feelings of gagging, discomfort & pain in my neck.
    Eventually I will have my back treated; but not sure what can be done; any opinions as to what anyone else with these conditions did to relieve there pain discomfort.
    X-ray said;
    multilevel disk space narrowing & osteophyte formation;multilevel spondylitic.
    The MRI said;
    C4-5 broad based disk osteophyte which flattens the anterior cord
    *C5-6 broad based disk posterior osteophyte producing deformity of the cord
    C6-7 posterior bulge
    T5-6 broad based disk bulge on sagittal plane mildly effacing the anterior thecal sac
    T7-8 mild broad based disk bulge mildly effaces the anterior thecal sac
    T8-9 mild broad based disk bulge mildly effaces the anterior thecal sac

    *21 Oct 10> I had ACDF w/plate on C5-6. The Dr. put the plate in wrong, it is touching the back of my throat, it has to be removed. (Jan 11)

    Thank you
  • I've been wondering the same thing. I've been having issues swallowing accompanied by some chest pain just above the sternum. I’m coming up on 8 weeks since a C6 – C7. I expressed these concerns to my Ortho Surgeon at 5 weeks and he pretty much blew me off saying it would go away in time. Saw my primary Dr this morning who wants to do a barium swallow study. The lump in my throat makes me feel like I constantly drowning and has triggered severe panic attacks. If removing the hardware will make that go away I’ll do it in a heartbeat.
    I’m curious as to why the surgeons don’t remove the devices when the Manufacture and Mfgrs Ass. Recommend it. I am(was)an active 42 year old. I still surf, skate, mountain bike and ride motorcycles along with other physical activity. From the documentation it sounds like leaving it in runs the risk of injury in active people so that alone makes me want it out.
    Quote from the Important info page in the Medtronic ZZEPHIR Anterior Cervical Plate System literature

    "5. The ZEPHIR™ Anterior Cervical System implants are temporary internal fixation devices.
    Internal fixation devices are designed to stabilize the operative site during the normal
    healing process. After the spine is fused, these devices serve no functional purpose and
    may be removed. In most patients removal is indicated because the implants are not
    intended to transfer or support forces developed during normal activities. If the device is
    not removed following completion of its intended use, one or more of the following
    complications may occur: (1) Corrosion, with localized tissue reaction or pain, (2)
    Migration of implant position possibly resulting in injury, (3) Risk of additional injury from
    postoperative trauma, (4) Bending, loosening and/or breakage, which could make removal
    impractical or difficult, (5) Pain, discomfort, or abnormal sensations due to the presence of
    the device, (6) Possible increased risk of infection, and (7) Bone loss due to stress
    While the surgeon must make the final decision on implant removal, it is the position of the
    Orthopedic Surgical Manufacturers Association that whenever possible and practical for the
    individual patient, bone fixation devices should be removed once their service as an aid to
    healing is accomplished, particularly in younger and more active patients. Any decision to
    remove the device should take into consideration the potential risk to the patient of a
    second surgical procedure and the difficulty of removal. Implant removal, should be
    followed by adequate postoperative management to avoid fracture."
  • Poodledad

    I feel you pain. Every swallow feels like I'm drowning. 5 week exrays show plate was ok and fusion was happening. My surgeon was really dismissive of my increasing dysphagia. I don't go back to see him until first week of Jan. Hopfully my Ins will approve and I can have the results of the swallow study before then. Like to hear how your proceedure goes. Wonder if recovery is as bad as initial proceedure.
  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    Very interesting. I don't have a clue what type plate I have but that is something everyone should be aware of before surgery. Hmmm.

    I'm sorry you're suffering from the lump too. I know exactly what you mean. I have to talk myself out of a panic attack sometimes to when it gets really bad. So far thankfully I can do that but know how easy it would be to panic!

    Please keep us updated on what the swallow test shows. If you'd like to discuss it further feel free to pm me.

  • sunny1966ssunny1966 VIRGINIAPosts: 1,385
    Welcome to spine health. I'm very interested in your progress. I too had the same surgery Oct.4 and am having problems with feeling a lump/choking all the time. I hope you don't suffer to much discomfort before time for the removal.
    Please keep us updated on your progress.

  • It is amazing how little information one gets before going into a procedure like this and the absolute lack of post operative care. I’ve found more information scouring these forums and other spine health / surgical websites. It’s interesting that given the number of articles I’ve found on the subject and the apparent commonness of dysphagia post ACDF you would thing that the surgeon would have mentioned it. As a surfer, one of my biggest fears is drowning. Now I walk around all day feeling like I am.
    My primary Dr put me on Klonopin to help control the Panic attacks which are starting to take over so we’ll see how that goes. Insurance Company needs to authorize the swallow study so it could be a few weeks. But I’ll post the findings.
    Primary Dr is running a full Metabolic, and Hormone panel to make sure no issues with thyroid or other underlying issues. As I’ve developed some other symptoms that surgeon says are unrelated to procedure and not consistent with normal recovery. Chest pains, sore lower back and abdomen muscles, fatigue and loss of appetite are just a few.
    One topic we discussed is possible side effects of going off pain meds. The Oxycodone and Hydrocodone that I’ve been taking at various doses and intervals since July may be causing me some residual withdrawal symptoms too.
    Sorry If I hijacked this thread – Fairly new to the board – feel free to ask me to start a new thread if I need to. Shawn
  • Thanx for the replies.
    The top two screws are not all the way in on the plate, this is the part that is touching my throat.
    I was told it is a titanium plate.
    I am now scheduled to see an Ear, nose & Throat Dr.
    I am under Workers Comp. Ins. so I have to wait for their approval on everything, so this has been a long drawn out injury. In the mean time I have to hope the bulges in my back do not get any worse.
    But so far, yes this is turning out to be worse than before the surgery; I have pain, discomfort & the over whelming feeling of choking.
    That is a very interesting quote from Zephir.
  • Hello, I went to the Ear, Nose, Throat Specialist, he thinks it's a hematoma that is causing the trouble, says it's along my spine at the surgery site. He set me up for a >Videofluoroscopy swallow study< He diagnosed my symtpoms as Dysphagia.
    He said if that is what it is it will take months to go away.
  • Well the plate is still in. The Dr wants to take it out but Workers Comp.Ins. won't approve it; Dr. asked twice, first WC Ins. says wait 2 more months, then after 2 months they did not approve it, Dr. is upset and going to release me. My Lawyer is going to appeal it. I am in Tennessee so I cannot get a second opinion. I have to wait until the Dr. releases me then start all over again.
  • Sorry to hear about these going wrong. I had my ACDF 9/2004 and my plate is still there and I've never looked back. My doctor did me the favor of taking pictures of the plate, my dlown disc, and the plate and BMP all in place at the end before closing. I'd be glad to share them if you want. I dont know if I can post them here.
  • Hello everyone, I appealed the surgery denial from the WC ins. But my Dr. now says that to take the plate out might not help and even make things worse, so he released my on MMI. My Lawyer will include in my case as part of the settlement being a new Dr. We also found out that the WC ins. company contract has expired with my job, at the same time of the surgery denial. Maybe a coinsidence?!?
    I also suffer from osteophytes and bulges in my t-spine, with another bulge and osteophyte impinging the cord in my c-4-5 & 6-7 & have suffered permanant nerve damage in my right arm.
    I haven't seen what ratings & restrictions I was given yet. Since he works for the WC Ins. company I hope he at least is honest about my symptoms and reflexs them in my ratings, my Lawyers does not think to highly of my Dr. due to past experience. We plan on getting an IME for court.
  • I had 4 level acdf in August, and ever since am short of breath, excessive mucus, problems swallowing and it feels like there is a golf ball in my throat or there are someones hands around my throat. Have some discomfort across my shoulders and right shoulder blade. still some numbness in little fingers. I almost think that it is either COPD< or a reaction to the titanium. I shattered an ankle and they put in titanium and had ro remove it because of swelling. Is this another major surgery???Thank you
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