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Rods & Screws to be added 1-year post op from ALIF L4-L5

Due to a failed fusion, my surgeon is suggesting that he's going to have to go back in and add rods and screws to stabilize my spine and allow the bone to continue fusing. He also intends to add more bone material.

A CT scan at 11 months showed lack of fusion, so I've been using a bone growth stimulator for just over 5 weeks. The x-rays yesterday show some bone growth on the front of the fusion area but none in the back. This is allowing the spine to move. I did have many months of what I thought was success after the surgery, with pain kicking in about 3 months ago (around 9 months post-op).

I've been searching through posts and not seeing where anyone had this done so long after the fusion surgery itself. He intends to go in from the back and said that this won't be as bad as the ALIF but will still be a 2.5 hr surgery and an overnight stay. No work for two weeks, and then a gradual return over the next 6 weeks or more.

My daughter gets married next month and I live 2,000 miles away. So the surgeon is going to wait until I return before he does another CT. He told me that with the number of planes I'll be stuck on, plus the hotel beds, lots of walking, etc., this will be the trip from hell. He is scheduling the CT for the Monday after my return, followed by an appointment with him on the Tuesday. His eagerness to get me in immediately after I return has me nervous. But I'm sure he would tell me if the trip was too dangerous for me.

Just wondering if anyone else has had an experience like this. Most of what I'm seeing is people getting rods removed at this point, not added. I always have to be different...lol.


  • Hi Allie and everyone. I'm new to the group.will just briefly explain my story. I had scoliosis surgery at 13years for a sudden onset 70 degree curvature. From L3 right up to my neck (rods) i then got pregnant and had twin girls in 2003 which wasn't ideal. From then by back deteriorated and the lower spine beneath the rod literally crumbled. So i had 2nd surgery in 2009, this time doubling up the rod to my neck but having it go right to the very base of spine and 2 more rods going out into each side of the pelvis. It was successful and all was good after recovery. Well that was what i thought, but it turns out all wasn't so great. One of the rods (titanium) snapped. The surgeon wasn't too concerned but then that led with the pressure to 2 other breaks. I kept going back for check ups and getting the 2nd in command and they decided to maybe take a screw out where there was a break as i was in so much pain. I then went for pre op assessment in Jan and saw the consultant. He couldn't believe how lopsided i was walking. Got be to x ray. Told me i now had 5 breaks caused by a further curvature in the lower spine that had been allowed to happen as the rods weren't doing their job ( even though docs said they weren't needed)
    So on 24th i went into Oxford for a 9hour op. Had the rods replaced and the curvature repaired. It was the worst op to date and for some reason the consultant said they need to do more work in a few months. (Less than 6) this time going in through the front. It seems never ending. Good luck all. Sorry if there are any typos. Its the meds and not being able to sleep at this hour. Lol
    Sarah Larkin-Smith
  • sandisandi Posts: 6,343
    edited 06/01/2014 - 4:01 PM
    Unfortunately, the rods being used can occassionally break, just as the heads of the screws can, when too much stress is put on them. That sounds like what occurred with you. I'm sorry for all that you are going through.....

  • Welcome Sarah :-)

    I haven't posted here in at least 6 months or so, and the reason I came back (no news is good news, right?) is because both of my rods have broken and the whole "cage" is floating around in my back. I wanted to talk to or read about someone else's misfortune because I have many questions and of course I can't remember them all because I've been up all night.

    I should really write my history down, but over the space of 2 years I had T11, L1,2,3,4,5 and S1 fused. I ended up with nerve damage on my right side. I can't walk and I'm in insane pain part of the time and numb the rest of the time. Fun. Can't do a lot of things anymore, including getting dressed, so I don't unless I have to go to the doctor.

    Now that both rods have broken down in the sacral area, I am off-balance - not lopsided like you, but top-heavy. It's scary! I will be sitting in a chair and suddenly take a header.

    My surgeon says the "next" operation will be The Big One. He wants to go in the back AND the front. I haven't had my appointment yet - too scared - but I was wondering if I could skip it. But Sarah, you said that your surgeon warned you of further breaks? That would make sense and I hadn't thought about it.

    So your surgeon replaced the rods??? Did they have to open you up from top to bottom? Did they have to replace all the screws and hardware as well?

    Does anyone know how the rods are held down? I emailed the news of my rods breaking to my family (across country) and my brother was asking me that. You see, at the hospital in Emergency they did an MRI immediately and told me I had broken two bones in my back. Then my surgeon emailed me and told me the rods had broken off and to please come in to see him about surgery. So that's all I know.

    Sorry if I'm rambling - I'm just going to post this and go to bed. I've been up all night in pain and now I'm exhausted.

  • If you have rods or screws broken off in your spine, then leaving them should not be an option.....the potential for permanent damage is too great. No one wants to have to undergo another surgery, but there are times and situations where you aren't left with too many other options. I wouldn't wait too long to make that appointment to see your surgeon. See what he says about the risks of not going ahead and going ahead. Then you may want to consider a second opinion, but again, I wouldn't wait too long to get one.
  • After reading about all this broken hardware, I'm very concerned about the potential for me to have rods and screws added to my existing fusion site. My CT is booked for July 7, followed by my appointment with the surgeon on July 8.

    Today I had a new symptom and I'm going to see how things go through the night. After getting home from work, I always change into comfy clothes and go to the bathroom. Without any impulse to go, urine was trickling down my leg before I could sit down. Now I'm panicked about CES. I'm 50, so I'm hoping this is menopause related and not CES. If I can make it another 12 hours without incident, I'll just take it easy. But one more incident and I'm off to the ER. My surgeon had mentioned that this was a possibility, highly unlikely, but possible. CES would prevent me from traveling to my daughter's wedding. I'm supposed to fly out this Saturday for her wedding the following Saturday. I'm so scared, I want to cry.
  • I was able to get in to see my surgeon yesterday. He did a rectal exam to rule out Cauda Equina Syndrome. All is well from his perspective. In fact, now he's talking about delaying the rods & screws surgery. I guess I wait until my CT on July 7th. Maybe something will show on the CT that will change his mind. I'd like to find out what is causing the new pain. Maybe it's time for a second opinion.
  • Pepperpot1808PPepperpot1808 Posts: 20
    edited 07/01/2014 - 9:39 AM
    Sandi, what kind of permanent damage are you thinking of? My surgeon doesn't give a damn. He is off on holidays after I had written him a scathing email about it being his duty to HELP me. I've been nagging and nagging and nagging, at the suggestion of a nurse who comes to my home each week to put dressings on my legs, but to no avail. He simply doesn't feel that this is his responsibility which frustrates me horribly.

    Allie, I have the same kind of incontinence that you described. It started about a month ago and I have no idea when I am going to urinate. Then it trickles down my weeping legs making them more infected and I end up in the hospital! I would say Yes, go to another doctor if you can, and remember this is *your* life.

    Right now I am going thru 14 diapers a day. "No one goes through that many!" snapped my social worker when I asked for help with funding for this. How mean to say to a sick person - does she think I;m lying and will hang out on the street corner hawking them...

    I've never been in childbirth, have had no problems with my vagina or cervix, but I did have a lot of urinary tract infections when I was younger. I can't figure out this incontinence and Allie, you say you have it too, so there must be a relationship between the surgery and the bladder. Of all people, my brother found me a solution which I haven't yet tried, but it has potential.

    I'm hoping that the urinary incontinence is not permanent - I got the lovely rectal exam as well and nothing. Meanwhile, I am stuck in the house crippled and peeing every 20 minutes. With a broken back.

    Allie, keep us updated (and on the wedding, too. How you coped) Sandi, I'd love for you to elaborate. Gotta go now. Take care everyone.


    Link removed, solicitation not permitted.Please read the Forum rules

    Post edited to remove name of specific hospitals and bashing of medical staff. by Liz The Spine-Health Moderator Team

    Post Edited by Liz The Spine-Health Moderator Team

  • I have forgotten how to get rid of my stupid footer- it makes sense to me but probably not to anyone else. I used to know HTML but like my life it's just gone!
  • can also cause damage to the bladder or bowels or both. It depends on what level the cords nerves are damaged at, and how extensively.
    I developed CES post op after my first surgery, and have it again, at three levels above where the first level was damaged....for me, it has damaged both my bladder and bowels. I wound up having to see a urologist, undergo urodynamic testing, over and over, and it was determined that the damage that I have is in fact, caused by the damage to the Cauda Equina. I was taught ISC ( intermittent self cathing) which does a lot to control the issues of overflow incontinence, as well as not being able to tell that I have to go......there is a similar program for those who have damage to the bowels as well, but it is more of a timed elimination program.
  • AllieO2000AAllieO2000 Posts: 49
    edited 07/06/2014 - 9:33 AM
    I just returned yesterday from my two week vacation which included six airplanes, five different beds, two countries, a wedding, and countless hours with kids, grandkids, other family, and friends. Amazingly, my back was a non-issue for almost the entire trip. Today my back/hip is bothering me more than through the entire trip. I picked up the lightest of the grandbabies - no issues. I had help with my luggage through most of the trip, but not on the return home. That may be the cause of today's issues. And no recurrence of the incontinence, so I continue to hope that CES is not my issue. I go for a CT tomorrow morning, followed by a surgeon appt on Tues morning. It will be interesting to see what improvement the CT shows.
  • sandi said:
    I developed CES post op after my first surgery, and have it again, at three levels above where the first level was damaged....for me, it has damaged both my bladder and bowels. I wound up having to see a urologist, undergo urodynamic testing, over and over, and it was determined that the damage that I have is in fact, caused by the damage to the Cauda Equina. I was taught ISC ( intermittent self cathing) which does a lot to control the issues of overflow incontinence, as well as not being able to tell that I have to go......there is a similar program for those who have damage to the bowels as well, but it is more of a timed elimination program.
    I'm sorry to hear that, Sandi. What I don't understand is how you can develop CES and then have it again. Is that what you mean by the different levels? I looked it up but find it difficult to understand. I swear that all the pain medication I've been taking for 5 years has eroded my brain.

    So when one gets CES it can damage bladder and bowels - you have the type of incontinence that I have, where one does not know when one is about to urinate? And this urodynamic testing is for determining WHY you have that damage? And is CES painful?

    I see ads on TV for catheters and often wonder how people know how to place them. So they teach you. Sometimes I think that would be awesome to have - especially as I can't walk without a walker and even then a trip to the bathroom can be SO far... and not knowing when I'm going to go is such a nuisance, isn't it? And your bowels!

    Did you end up with any damage to your legs? I hope not. Dealing with elimination is enough!
  • due to the severe amount of swelling and fluid buildup.......they were supposed to do the surgery on three levels of the lumbar spine and only did one, with hemilaminectomy on the one level, a total fusion on the second level and the third level removed a herniation. This left the canal compromised and when the swelling started, it closed off the canal.
    I had a "salvage" operation to try to relieve some of the compression 18 months later, to try to preserve my ability to walk, and to replace two screws that had backed out of the vertebra, along with trying to relieve the compression of the canal......they also refused the fusion area that did not fuse the first time....they added bmp ( bone morphegenic protein) in the lumbar area posteriorly, which it is not supposed to be used for, and that migrated, causing a second onset of CES at higher levels than previously.
    Yes, CES can effect both the bladder and bowels or one or the other, depending on the levels involved in the damage. There are several ways that CES can damage the bladder or bowels, depending on what levels are involved. Not being able to tell you have to go, not being able to empty or only partially empty, or damage that involves not being able to hold it in......I have a mixture of all of the above, due to the various levels involved.
    The urodynamic testing is done for a couple of reasons, to ensure that there is nothing structurally wrong that may be contributing to what problems you are having, then to rule in or out, possiblities, to measure how much urine you are retaining, and if you can empty the bladder on your own, as well as how much and how fast the flow is or isn't......there is an emg that can be done to determine where the damage is coming from, which is how they determined that it was from the spine nerve damage. It wasn't the most pleasant experience I've ever had, but thankfully the doctor and his staff were really good at helping to set me at ease and working with me to make it as comfortable as it could be.
    They teach ISC in the office and once you get it, you find that it is not as bad as you thought it would be.....in fact, at least now I don't have to worry as much about public accidents as I once did.
    Yes, CES is painful, but thankfully over these last 8 years I have learned to cope with it and learned to handle it better and things do improve over time.......As far as damage to my legs goes, I have bilateral total foot drop and my muscles are signficantly weaker than they once were, both legs are numb and I have little to no reflexes in my legs, ankles or knees but it is what it is......and I manage far better now than I did when it happened.
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