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Prominent L4/L5/S1 hardware removal?


Im new to the community and read through old posts looking for some answers to my thoughts, but noticed most all the posts were old. So I thought I would ask a few questions.

I was born with a Pars Defect and at the age of 34 had a MIS TLIF L4/L5/S1 fusion with spacers. It was a life saver. I lasted as long as I could but eventually at a 50% slip the pain was so bad that never walking again seemed a small price to pay to be out of pain. Luckily, I saw an excellent surgeon and was a prime candidate: I remained as active as possible until the end, I was young, thin (yes, very thin), etc etc. I am not going to lie, the surgery was horribly painful and the rehab took extra long. But, I rehabbed excellently and began long-distance road biking as well as resuming other physical activity.

About two years ago, slowly, I developed pain that radiated from my surgery sight. Eventually that pain localized itself to 4 lumps on my back. Surprisingly, those 4 lumps are my screw heads and can be felt (and seven when I bend over). Over time, I have developed a "catching" sensation which I believe is scar tissue building as my muscles move over the top of the screen heads. When the pain is bad, if I press on those screws, it hurts. It feels like the tissue is deeply bruised. Then my back goes crazy and I have spasms. So, prominent hardware it is. I have worked with my surgeon who is unbelievably helpful. We started conservative and eventually I tried localized steroidal injections. Within MINUTES my pain went away. It came back slightly after a few days, then disappeared. That was 5 months ago. His comment at the time was "Don't lose any weight and don't expect PT to make this better, this is a mechanical muscle issue." He said that I had developed patellar bursitis. I do have a broken screw, and a loose screw. But the surgeon is confidant I have a solid fusion and also pretty confidant that its not my source of pain specifically. 

But, the pain is slowly returning and I am wondering about having a hardware removal. Its important to stress that I am a very active and fit person, so the idea of not moving around to avoid the tissue rubbing is difficult Plus I have little kids and well, they require a lot of moving around!

Has anyone had a hardware removal for something like this? If so, how has that turned out? Has anyone just stuck with steroidal shots 1-3 times a year instead? I really appreciate your time in reading all this. Having gone through so much pain for so very long I appreciate opinions from people who have "walked the gauntlet" themselves.



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