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Hi! micro movement after a fusion (L5-S1)

Hi everyone, I'm new to this site. I had started my own blog to try and connect with people in the same situation as me but now I have found this website, I think I may have hit the jack pot! I'm even more interested as I live in the UK and I think most of the members here are from the USA and you might be more knowledgeable to help me with my current problem.

I used to train polo ponies for a living. I suffered a severe crush injury to my pelvis in November 2000, ruptured a disc completely and had a fusion at L5-S1 in February 2001. Life after that was very different but I managed to work in an office. My physical life and abilities were changed forever.

In 2010 pain returned and I had 1 set of injections and then a denervation. In February 2011, my neurosurgeon decided to remove the screws from my fusion (leaving the cages in, obviously!). I was okay for about 2 months post-op, then the pain returned and I have been struggling ever since (+ 2 more sets of unsuccessful injections).

I'm off work, sofa bound, and cannot find any medication to help with the pain. No abnormalities are showing up on either x-rays or MRI's.

I have been seeing a specialist spinal rehabilitation physiotherapist for a year now - the same physio who treated me in 2001 after my fusion. In August this year, he identified an area of damaged tissue, where one of my screws was taken out and I have been having HBOT and laser treatment, along with physio to heal this - which is working (hurrah!).

My ultimate problem is that although the tissue damage is healing, I am still in huge amounts of pain and my physio thinks that after my screws have been taken out, that I now have micro movement in my fusion. Its been destabilised.

My physio is on a mission to get my core, legs and shoulders as strong as possible. He tells me that this will help. As I cannot walk more than 100metres or sit or stand for more than 10-20 minutes - all exercises have to be carried out lying down. Thankfully, after 2 and half years of trauma and pain, at least in the past 3 weeks, with the tissue damage healing, I can actually do these exercises.

I am looked after by a very good neurosurgeon in the UK who also works in the USA. He told me that in the USA, screws in a fusion are removed as a matter of course 18months after a fusion. This is not the norm in the UK and screws are only removed if they are causing a problem.

Does anyone have experience of micro movement in a fusion and how was it treated? I'd be very grateful to hear any of your experiences.

Pelvic crush injury, L5-S1 fusion 2001, screws removed 2010


  • and i've never heard of screws being removed at 18 months unless there was a problem with the hardware. i've got 2 fusions, and i don't have any expectations of having the hardware removed, unless it becomes a problem down the road.
    Microdisectomy / hemi-laminectomy 6/2010 and revision 10/2010
    Cervical fusion C4-5 and C5-6 9/2011
    Lumbar Fusion L5-S1 6/2012
  • CharleyLLCCharleyLL Posts: 4
    edited 11/27/2012 - 7:20 AM
    Many thanks for your comment. Its's very interesting to hear that you have no knowledge of screws being removed after fusions in the USA. This makes me more curious as to how many people have had their screws removed and if it has caused them destabilising problems. Thanks again.
    Pelvic crush injury, L5-S1 fusion 2001, screws removed 2010
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