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Pedicle Screw Broke in Half

I had a two level lumbar fusion over 2 years ago.  Never fully recovered and over the past year have gotten worse, consistently.  Told by my NS today that one of the eight pedicle screws is broke in half.  Suggesting revision fusion with pedicle screws being screwed into the pelvic bone.  Anyone out there have any feedback or knowledge on this?  Very bummed out....
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Comments

  • hvillshhvills Suzhou, ChinaPosts: 964

    Lisa

    I also had a two level lumbar fusion in 2013 where one of the pedicle screws broke after 18 months and I had to have a complete clean out and redo of the L5-S1 level fusion with new hardware.    It seems that my bone fusion at that level was weak and incomplete which ended up putting too much stress on the pedicle screw over time... which then broke and subsequently the bone fusion slipped causing massive pressure on my nerve roots at that level.  Yeah it really sucks and is a total bummer but there isn't much you can do about it except get a redo fusion surgery or at a minimum new hardware.  The suggestion by your NS to use pelvic bone screws seems like a good one as it will help to further stabilize your spine during fusion growth.  Have you had any imaging to confirm the completeness and status of your bone fusion(s)?  What about the cause of your nerve pain?    BTW... you said 8 screws... did you have a two level or three level fusion surgery?

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • LeeLeeMccDeeLLeeLeeMccDee Boston MAPosts: 171
    Hi Harry,  thanks for sharing your story   Very similar to my own    Yes I had a Two level fusion at L5/S1 & L4/5 (anterior/posterior incisions).  My CT report came back with the status as : "no evidence of solid osseous union" at either level.  So in conjunction of the broken pedicle screw implies movement of that area.  NS says severe stenosis at L3/4 due to moderate diffuse bulge at that level is cause of new pain in hip and front of leg.  I have decided to proceed with surgery albeit very apprehensive...scared really.  He will remove broken screw and only remove the other hardware if compromised   He is using donor bone, my own and BMP for the graft...then add the pelvic screws   Should be cemented after this process. Oh yes he will be including L3/4 to make it a 3 level fusion..posterior approach only.  May I ask why your Dr didn't use pelvic screws? And are you feeling better?  Are you fused and what is your pain level and activity level   If I am asking too many questions I apologize   Just like to get as much feedback as I can.
    Thank You!!
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  • hvillshhvills Suzhou, ChinaPosts: 964

    Lisa

    You need to do everything you can to ensure you get a good fusion this time. Do you know of any reason why your first fusion didn't take??  Do you smoke... take NSAIDS...??   I would also ask your Dr if it makes sense to do an anterior/posterior procedure.  With the anterior approach he can get a bigger cage and more bone matter into your disc space than with a posterior only approach.

    In my case I'm not sure why my Dr didn't use pelvic screws the second time around... if I had known about them prior to my surgery and how they can help I would have asked him... but they never came up.  Again I think the idea from your Dr to use them is a good one... but that is just my opinion.

    I'm fully fused but it took a longggg time... at least 12 months and even then it took another 6 months on top of that for all of the various daily nagging pains and discomforts to go away and for my back/body to really feel solid again.  I'm not 100% pain free but pretty close.  Activity wise I walk 30 minutes daily and swim 30 minutes 4-5 times a week... swimming it the best, I really like it.  I do not do any kind of running or other stressful spine jarring activities.  I do not risk lifting anything over about 10 pounds... and any kind of twisting or bending is done very slowly and carefully with very deliberately steps.  Gone are the days of just bending over to the floor without thinking...

    I also had a badly herniated disc at L3-L4 at the time of my second fusion surgery and the Dr wanted to fuse that level as well... to bring the total fusion to 3 levels.. but I wouldn't let him.  At the time I had read/heard too many issues or concerns with 3 level lumbar fusions.  However in hind sight I wish I had let him do the fusion at that level.  Now the disc space at that level due to the discectomy is essentially zero and that joint has more or less auto-fused.  I also think that since this joint wasn't properly fused in surgery is part of the reason why my recovery took so long.

    There were many times over the past months when I thought I would never get back to "normal" but within just the past 5-6 weeks at 18 months post-op I finally feel like I'm about there.  I'm pretty solid and comfortable most of the time.  Sometimes when I sit in the car for more than hour I feel like I need to get out and walk and stretch a bit as it's just too uncomfortable.  Also there are some days when I get up in the morning I feel a bit "shakey" and a bit of pain in my lower back... but it doesn't last long once I get moving.   Knock on wood... I hope I can maintain at least this status moving forward.

    Don't be scarred of the surgery... the recovery isn't easy or fast... but in the end it will get you your "normal" life back.

    Harry - 65 year old male...
    PLIF L4-L5-S1 due to disc degeneration... May 23, 2013
    PLIF L5-S1 due to failed fusion and broken screw... Jan 19, 2015
    Microdiscectomy, decompression L3-L4 due to herniated disc... Jan 19, 2015
  • My pain doctor found my broken screw when he did a certain angle of my back x-ray for my pain shot so I have no idea how long mine was broken because I just started going to him after I was finished with my neurosurgeon who really just asked how I was and said in pain, oh it takes 2 years to heal so that's what I was expecting until the picture of the broken screw so I stopped with him and started getting shots and made an appointment with a orthopedic spine surgeon who came highly recommended and he fixed the problem but left the screw in my back broken because it would have been worse if I had taken it out so he put in a new one and I am done.  Still have pain in back, legs and hips which are a sign of "why did I have the first surgery to begin with" because I am now in the category of FLS Failed Laminectomy Syndrome aka failed surgery ... not from the broken screw but from comments my new surgeon makes like I would have done it like this, this and this, not like that or that keeping it secret not to talk bad about another doctor so I am sad and in pain all the time but the screw surgery was a piece of cake and worth it!
    Linda
  • LeeLeeMccDeeLLeeLeeMccDee Boston MAPosts: 171
    Hi Linda, thanks for sharing.  Isn't it awful to feel so negatively about the Dr's who are in charge of " our future wellbeing".  My NS says I am his 1% of patient that ever had this kind of complication (fractured vertebrae due to fusion cage being too tight). I try not to dwell on it too much but it's hard not too.  I feel like so much of my life has been wasted waiting "to get better".  Now having to have this 5th surgery is distressing and my outlook for a normal life a.k.a. not being limited with my choices in life are poor at best.  I also feel really bad for my husband who has been very supportive but has heard me say " sorry, I really don't feel like doing this or that" due to the constant meds and discomfort that eventually comes.   I never complain to anyone and say yes to things I shouldn't be physically doing.  I don't want anyone feeling "sorry" for me so I keep everything to myself and few know the status of my back.  
    Did your Doc place pelvic screws to stabilize your fusion?  Were you "fused" with your own bone or synthetic?  Do you work?  
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