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removing hardware from lumbar fusion

Has anyone ever had their fusion hardware removed (cages, screws or rods - I have all 3) as a way to alleviate chronic back pain? A member on the site mentioned that to me and thought there was a test that can be done to determine if the hardware is a problem. Does anyone know anything about this? I would think that hardware removal would require the surgeon to break the bony fusion that has developed at the surgical site - potentially leading back to instability at that segment. Am I missing something??


  • I just had hardware put in about 5 weeks ago. (L5 S1 fusion) From the reading I've been given ,it says "unless there are problems, the hardware can stay in". I've heard of an older fella on another thread that said he had to have his hardware taken out because of a recall?? I'm not aware of any test that can be done? You're surgeon should be able to answer your question easily.


    Different degrees of back pain since 1994
    Cortisone shots Jan/09
    Discectomy and lamenectomy April/09
    L5 - S1 spinal fusion July.13th/12
  • I've had my hardware removed. I understand that cages are not usually removed, just rods and screws.

    During a surgery, the surgeon can do sort of like an internal EMG to see if hardware is impinging on nerve electrical signals. Probably bad explanation, but that's how I understand it. That is only done during the surgery, usually when hardware is placed.

    I think you may have heard of a hardware block. This is what I understand, but please ask your own doctor. You are prepped similar to getting an epidural injection. The physician injects lidocaine or some other numbing agent around the hardware and in theory, if your pain goes away then you know the hardware is the offensive item. However, this doesn't really make sense. The lidocaine cannot be contained to just touch the area of the hardware, it is a liquid and leaks all over. The hardware cannot be isolated.

    After you are fused, if you still have unresolved or unexplained pain, hardware is sometimes removed. One advantage as I saw it was that it gave my surgeon an opportunity to visualize the whole area and look for things that cannot be seen clearly on scans. Also, that was one less thing to be harboring my infection and the hardware itself had issues.

    I had so much going on that I felt like I needed to have the hardware removed just to make sure it wasn't the cause. I really felt like I had to explore every option to make sure nothing mechanical was causing problems before I accepted this "new me." Remember, this is just my experience. I really think you should ask your physician what he thinks. Use the info you read here to help you open a dialog. Like, "I've heard some people get their hardware out when they have new/worse pain. In your experience, does it help and how often do you do it?" While I found the hardware removal surgery to be an easy surgery to recover from, please keep in mind that it is surgery, every time you are cut open you risk so much especially infection and further problems such as arachnoiditis from repeated surgeries.
  • MarniMMarni Posts: 45
    edited 08/26/2012 - 5:21 PM
    Thanks for your comments. I really appreciate your insight. Before my 2nd and 3 rd fusions, my surgeon was going to remove my cages, but opted against it in the end. You're right, removing the cages is much more difficult.

    I actually have had my PMD coat my hardware with cortisone (with flouro guidance), but it's hard to tell whether it helped because I have so many other pain sources, as you say, its tough to isolate. Now that I have had my SI rhizotomies and dealt with the SI pain, I may ask him to the 'coating' again to see what happens. Thanks again.
  • One of the screws in my spine loosened, causing increased, and differing pain. they removed not only the one offending screw, but ALL of the hardware, since they were already in there. the operation was "a piece of cake' compared to the other 9 spine surgeries I have endured. good luck to you/
  • I feel obligated to post because rarely does anyone stating they have hardware issues ever come back to bring closure to their complaints after finding solutions. I hope this brings some encouragement or hope to someone out there who's going through what I went through. My life was hell for 3 years. I had 4 discectomies because of ruptures that happened 6-8 weeks after each surgery. Finally my surgeon said I needed a fusion; he recommended a new surgeon. I went to Boston and was told by the best surgeon that my discs were deteriorated and I needed fusion from L2-S1 to mitigate the chronic herniations. My wife nodded her head in agreement as the words came out of his mouth so I agreed to a 3 surgery operation. I was told 12 weeks recovery (that's merely for the surgical wound and the fusion to show progress). Unfortunately, I experienced sharp pain in my spine at 12 weeks. I also came out of surgery with severely worsened L4 nerve root pain in my left leg, isolated in my left knee. The pain in my upper back worsened for another. 8 weeks until I was completely bed ridden. I couldn't do much (prepare meals, drive, pick up after myself etc.), because everything I did caused severe pain. A ride in the car left me in excruciating pain for several days. I couldn't sit up or even have a normal meal with my two children at the dinner table. I complained to my surgeon over and over, seeing him every month. He didn't want to do surgery because the fusion looked good and none of the hardware appeared loose or migrated according to CT scans. After 10 months of agony, I asked my pain specialist for a hardware block. It worked instantly!! The pain went away and my wife and I went out to lunch! I immediately scheduled surgery to remove the hardware and I'm now 9 weeks out from that surgery. It was a success and I feel very good. It was not the easiest surgery. Hardware removal for me, was 4 levels so, it was a little more recovery than discectomy but, I was definitely stronger than a discectomy surgery. PT released me without recommending further therapy. I still have left leg nerve damage from the fusion surgery. I still have back pain. I will always have back pain because I have had 8 surgeries in total. I hope this info helps somebody who thinks their hardware might've causing problems - it put me through absolute hell for almost a year and the problem didn't show up on scans. Good luck to everyone here.
  • cathy palmaccathy palma Posts: 32
    edited 11/09/2014 - 11:16 AM
    I had my surgery on the 17th of Sept only to now have to have it removed or replaced I had a allergic reaction to the rods and screws they say it's only going to be a hour surgery as I'm healing well already have bone growth I was just wondering if anyone had it replaced ?? other then the reaction I was feeling wonderful doing Pt but not able too work how long will it take to get back where I was at ??? the DR said it should be a easy surgery ???
    cathy palma
  • I had my old hardware (from 3-level fusion) removed and replaced with new harware in order to complete a 6-level fusion. The total time for the second surgery was 3 hr and 15 min, a bit less than the first surgery was. I am five days short of 3 months in my recovery, and I am right on target what could be expected. So at least in my case, the hardware removal did not complicate things. Compared to many people on this forum, I consider mine to be an easy (relatively speaking) surgery. If your Dr. said the same to you, you have every reason to be optimistic and take his word for it. Good luck and let us know how it went.
  • Thank you Kinpain my fusion is l5 s1 and like I said I was doing great then came the hives and every other thing lol not pretty they have me on prednisone right now keeping things at bay but I should be off them by Thur that means nothing but allergy pills for 6 days oh and a epi pen I heal well so I'm hoping he's right I had my neck fusion in 2008 and they used titanium but on this one they used colbolt chrome rods steel so it has some nickel in it I was good for the first 3 weeks then all hell broke lose feel better thank you
    cathy palma
  • And from what I know, even that could contain a small amount of nickel, but maybe less than what yours has. Discuss this with your surgeon, although it sounds like he is aware of this. Hope all goes well for you this time!
  • I have never heard of a test that could be done to determine if the hardware is the problem. I had a partial hardware removal and for me I have so much pain due to different reasons that it is hard to see benefit for me at this point. If they remove hardware they will not break the fusion. They will leave it how it is if it is fully fused. When I had my last surgery which was 3 weeks ago it had a failed fusion so she sis remove bone from there but when she removed hardware from another spot which has fused she left it as is.
  • ok going on 4 days now had the hardware removed and replaced with titanium still have pain from surgery area stiff walking but NO HIVES !!! stomach is getting back to normal thank God don't know what else is coming my way see the Dr on the first :)
    cathy palma
  • normsundnnormsund Posts: 1
    edited 08/07/2015 - 8:47 PM
    I had L5 S1 spinal fusion 14 months ago, I have had pain since then ( I had 3 faccette, 3 nerve blocks and 2 SI joint injections with no results, , I have seen 3 different surgeons and they all are at a loss why I have the pain, they say everything looks good ,but I still have a constant stabbing in the lower left back just over the buttox near the spine, at the same time there is a burning sensation that makes my left button hurt so much I cant sit. I am wondering if it could be hardware related?? anyone experience similar pain?
    thank you

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  • SuperFusionx5SSuperFusionx5 Posts: 1
    edited 08/07/2015 - 8:48 PM
    To answer your question: yes !!!!! there is a test ! I had it done (out pt procedure) I had a 3 level fusion of the lumbar 10 yrs ago @ age 29. 7 months after going through the surgery my body was rejecting the instrumentations (screws and rods) . In order to make sure of this rejection you have to have a procedure like having nerve block on your stomach awake it takes all of 15 -20 minutes to fine out . The up side is you will know right then and there if in fact it is your body rejecting the hardware. It's an injection (epidural like) pretty simple you are given the injection under real time X-ray after the injection is given if you feel no pain that means he muscles settled down and In fact your body is fighting your hardware as it is a foreign object placed inside your body. So I felt relief for about 20 or so minutes then had a lot of discomfort after words had to pop pain pills for that one. I was then sent back into the OR to have it taken out at nine month marker since first having the fusion ( had to make sure the fusion was totally fused first) and I now have a very nice amount Nuts, bolts,screws and rods to make a pretty cool wind chime. I'm still in pain every fricken day but I deal with it and life goes on. I have also taken part in a cervical,fusion and a thing called Mobi-c for the cervical just finished my last test after working with the FDA on this now accepted in the United states experimental test on a hand full of chosen people to have disc replacements in the neck I had two and that hasn't help with pain not one bit but at least I can walk I have to say now at almost 40 I am greatful and don't regreat having it done I was born with this handed down from generations before me with DDD & DJD ( degenerative disc & joint ) lucky me. But I am lucky cause I can still walk up right and have all my limbs. Yeah I have pain but so does everyone else why waste time and complain. I leave with this little note that I grew up with reading each and everyday: I use to complain because I had no shoes ..., until I met the man that had no feet. God bless y'all hope this helps YA out if any type-0 sorry no ones perfect and I'm sure you can sound it out! Almost forgot anyone at anytime that has had a fusion with instrumentation can go through this rejection my surgeon just took hard wear out of a man that has had his hardware in for 18 years and was rejecting it now , crazy I know! But so very true! I

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  • Bowser8itBBowser8it Posts: 1
    edited 08/07/2015 - 8:49 PM
    It's been a year and six months since the fusion. My surgeon is one of the top ten in Dallas, so I trust him. My ruined disks pain is gone, but a new pain has developed. Everyone here knows what that hardware pain is. I have six screws and rods, two spacers (which will stay in, I think), and a bone-building device. Epidurals and injections don't work. Thank goodness they used donated bone and didn't get it from my hip. I'm old: 76, but always tough and active. I'm struggling with pain 24/7 and all the meds. Thanks for all the posts. It's like armor you can put on when you're getting ready to go in.

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  • I am getting ready to have hardware removal on a 15 yr old fusion l5s1 neurosurgeon says 2 weeks recovery on an outpatient procedure. The hardware has twisted causing one screw to go into the disc space and the other side to press out through my skin. I am curious if anyone has had this happen to them. My pain specialist says there is a good percentage this will drastically help because the ESI injections have been so successful. He said that is a good way to tell or test if a patient will respond well to hardware removal. If you don't respond well or have pain relief from the epidural steroid injections then the hardware may not be the source of pain.
  • SavageSavage United StatesPosts: 5,427

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  • My son had a lumbar fusion at two levels in April of 2013. He was 19 at the time. He began having issues with the hardware and the surgeon removed all of it in September, 2015. Amazing results! He is doing better than we could ever have imagined possible. Just a few days after surgery he could tell that the pain level had drastically reduced. Improvements have continued and it has been wonderful! Not a completely smooth recovery due to a few relatively minor complications, but overall an amazing improvement in the quality of life for him! A true surgical success! Hope everyone facing this procedure has results as good. Best wishes.
  • After reading all of the post it makes me feel better about getting mine removed. I've had L5 S1 fused since 2002 & not been right for a long time. 1 of my screws backed out & now is laying on my nerve. I've got what I call dead leg from it. I'll be fine then my leg goes numb & I fall. Everything above & below my fusion had herniated as well. Massive scar tissue isn't helping either. I've had 100's of injections over 14 years. Only a few helped. Pain meds became so much of my life I could no longer function without them. Becoming addicted to something meant to help was hard. Now I suffer, without my pain meds, & need a lasting fix of my spine. Now to get my husband on board with a 5th spinal surgery! That may be harder than the recovery.
  • SavageSavage United StatesPosts: 5,427
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  • In 2014 I broke my back thanks to my lovely horse. In 2015 I had my L4/L5/S1 fused along with a lamenectomy. Ever since the surgery I was not able to move three of my toes and my leg was numb. My Doctor told me that it was nerve issues and that within 6 months it should return back to normal. Also my pain has increased dramatically. I can't sit stand or do hardly anything without hurting like crazy. I've been dealing with the pain because I don't want to get hooked on medication. I went to see a Neurosurgeon and he had me do a Mylogram. The results showed my screws are loose my 2mm and my bone graft did not take . Now I have a choice to have the hardware removed or replace it with new hardware on the right side. My gut tells me to remove it altogether but I'm concerned about stability in my back. Has anyone ever had a fusion done and hardware removed without the bone graft being fused???

    I'm so frustrated because I've always been a very active person and I love to ride my horses. I just want to be able to ride and four wheel in my jeep like I use too!

  • My doctor is suggesting injections, blocks, to see if hardware removal is appropriate. I have constant aching on the right side where hardware is in my back and I am at 2 years post surgery, fusion at L4, L5, S1. I don't think there is any real scientific proof that the blocks will mean anything as the medication will affect nerves, muscles, etc. Anyone out there experience any relief from hardware removal????
  • SistaHollywoodSSistaHollywood Nashville TennesseePosts: 1

    I have had 9 back surgeries and 4 wound vac surgeries due to infections after surgery The  last one was 2 yrs ago and I am at my wits end. I hurt 24/7 my right side, lower groin area and the upper left side and basically all over. I have tingling in my hands and feet and my stomach is bloated with it  contracting off and own and it feels like someone is squeezing me in the upper stomach area. My last surgeon who operated has retired and I went to the new doctor who took his place and he told me my hardware needed to be removed but it was an extensive surgery which he could not perform unless I had a blood transfusion and due to Religious reasons that is not possible Did those who had hardware removal require blood and what city dio you live in since I am looking for a back surgeon who will do bloodless back surgery  Thank9.

  • I was wondering what kind of bad reaction you had to the metal. And what level? Did your fusion work? 
    I had L5 S1 almost 2 years ago. My back has not fused. I have the inter body cage and titanium screws and rods. I have  had several bad reactions, I believe to the metal. 
    I am currently looking for a surgeon that will remove the hardware, add more bone graft, and see if my body will heal, w/o the metal. ( I seem to have a allergic reaction to some the nickel alloys in the titanium.)
  • I have the same question. No surgeon, I know, will remove the hardware if the fusion has failed. I strongly believe that the metal  is causing havoc on my immune system, and making it impossible for me to heal!! But I do not know the solution, and I too am in constant pain. 
  • LizLiz Posts: 7,832
    Hello YMG

    This is an old discussion created by a member no longer on the forum so I am closing it.

    You can search for articles on this subject or I suggest you create a new discussion

    Liz, Spine-health Moderator

    Spinal stenosis since 1995
    Lumber decompression surgery S1 L5-L3[1996]
    Cervical stenosis, so far avoided surgery
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