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Revision Surgery and Existing Screw/Robs, do they always replace them?

davidwright242ddavidwright242 Posts: 32
edited 09/22/2014 - 1:36 PM in Back Surgery and Neck Surgery
I am facing a L4-L5 revision surgery due to a failed fusion from late last year (Nov-2013), and I am looking up options as to which route to go. . . but one thing I can't seem to find much information about is why are the screw/rods are commonly removed and replaced during a revision? Even if they are not loose?

I have looked at my CT scans and those screws are MASSIVE, I would think that even removing them would be a serious serious undertaking, I can't imagine there being any lumbar strength left to put anything back in. My screws and robs are actually part of a system (Exactech Silverbolt) and they are completely solid according to my orthopedic dr., I would think that loosening the rods would be the way to go to reduce the tension on the vertebrae to get access between, but I've never heard about a revision going this way, but maybe it's just my limited experience.

Anyone have any information? or maybe a personal experience they are willing to share?

Thanks for anything you have to add.
--) Dave (--


  • Hi David,

    Less than 6 weeks ago I had the hardware removed that I got six years ago when I had an L3-S1 fusion. Since the vertebra above the fusion site collapsed, and the spinal column bent forward, my surgents had to stabilize it by inserting longer rods and more screws. They no longer make the old hardware, so he had to replace it with the new and improved hardware. I am not sure if you also will need new hardware once the old one is removed, as if your fusion is complete and no further correction is needed, your dr. may just leave it as that. He is the best person to ask about what is going to happen.
  • Thank you for the info. The reason I am asking is that the screws are so massive that were put in me (as with most people) that I can't imagine taking them out and putting something else back in the same area, or even around the same area without it simply not working. Its kind of like trying to drill a hole in right next to another hole in a piece of wood and putting a screw in, it's going to destroy the wood since there is nothing left for the screw to grab onto!!! That is how I see my screws from the CT scan, they are a epic structure that appear to be taking up most of the vertebrae area.

    Did they put the screws and robs in the side or front this time maybe? what kind of surgery did you have this time? a ALIF-PLIF 360 I assume?

    --) Dave (--
  • For vertebrae T12-S1. I guess it was a PLIF. Both time from the back, except this time it is longer. Yes, the screws, all 14 of them, are quit big, but in proportion to the rods. The whole incision required 24 sutures. Amazingly, my surgeon was able to peel the muscles off the spinal column after the incision was made, without cutting the muscles. This technique saved me from lots of unnecessary post-surgical pain.
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