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Removal of hardware after a fusion

From: shadding - on 02/16/2011 7:32pm

In Dec of 2009 I had a fusion of the L5 S1 with a plate and 2 screws put in. The pain I was having was gone after surgery but a new pain started at the surgery site. The pain is getting worse and worse. I cant do much of anything anymore. I have been telling my doctor, my physical therapist and my pain management CNP about the pain and that I felt like it was the hardware causing the pain. Finally one year after after surgery I asked my neurosurgeon about removing the hardware. Yes, I had to ask. He said that he could remove it and replace it with bone. The pain is so bad that I am ready to do it. But I have heard that removing bone from your hip can cause problems with your hip. Has anyone had this done? Could you tell me what to expect? Thank you.

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on 02/20/2011 12:05pm

Hi shadding. I had l4-l5 fusion +lamenectomy in Dec 2009. My screws are causing bursas b/c I am so thin, my neuro suggested taking them out to relieve pain as the fusion is solid. My neurologist is not keen on it as I have other problems and he is not convinced I will get the result I am looking for. But it is on hold for other medical reasons right now anyway.

Now about the hip bone, that is old school and really most up to date surgeons no longer do that b/c the downtime and recovery for patient is much longer and more painful. I am curious about the plate since I know they are using same protein material that was used on me on your type of surgery as well, actually for almost ALL fusions as it less invasive that hip grafting. (which would be quite painful and longer recovery) If your surgeon is going to replace it with bone, you are going to go thru the same type of surgery as before and be starting at sq. 1. I would STRONGLY urge you to consult with another neurosurgeon. If you want to tell me where you are located I might be able to help you with referrals.

I'm afraid to say but I think your doctor did you wrong. But that is JMO based on the little you said. He/she may have had other reasons for using plate, I don't know. But from what you say, I would be righteously pissed off with him/her right about now!

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on 02/25/2011 6:05pm

hello and get better, i had the same surgery 9/09 and still have the hardware as i write you. i must tell you that focus on pain is not helpful and can hinder the progress as we will depend on meds(pain)and we should be focusing on losing the extra weight,more heavy core exercises,stretching muscles around the area,and walking as much as you want, i'\ am666 years old and not about to let the hardware/fuse or anything else get in my way, i am self motivated to improve my condition , by any mental/physical/spiritual means necessary and don't plan to deviate, STAY strong/FOCUS

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on 02/25/2011 7:54pm

keep pushing toward losing extra weight,focus on extra core strength exercise,remember,no pain,no gain,actually,i walk every day for about 1 hr,do core exercises,stretching muscles in problem areas,stay focused on self-motivation and go for it,it might hurt,but think about how it was before,now go at it,do it,see ya in the olympics,get better.

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on 03/03/2011 8:09am

I had a double fusion done a year a go and have had bad back pain my ortho doctor said the same thing I could try removing the screws but I do not know what this will do for me.If any one has had this done or knows about it can you please let me know your out come did your back pain get any better L4 L5 S1 As of now I cant do much and the life sucks big time because I can"t stand walk sit or bend to long with out having sever pain that just puts me on the couch laying down feels much better I want my life back,,,,,,,,,,,,,,,Can someone help me out on this one .So yes it was a double fusion and it was a year a go still in very very bad lower back pain if any one has had the screws removed after a fusion can you give me your input on this type of suergery and how long the recovery was befor you could do things thanks,,,,,,,,,,,Someone out their must have had this done please get back to me if that some one is you;;;;;;;;;;;;;;;;;Have a nice pain free day I hope.

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on 03/03/2011 8:10am

I had a double fusion done a year a go and have had bad back pain my ortho doctor said the same thing I could try removing the screws but I do not know what this will do for me.If any one has had this done or knows about it can you please let me know your out come did your back pain get any better L4 L5 S1 As of now I cant do much and the life sucks big time because I can"t stand walk sit or bend to long with out having sever pain that just puts me on the couch laying down feels much better I want my life back,,,,,,,,,,,,,,,Can someone help me out on this one .So yes it was a double fusion and it was a year a go still in very very bad lower back pain if any one has had the screws removed after a fusion can you give me your input on this type of suergery and how long the recovery was befor you could do things thanks,,,,,,,,,,,Someone out their must have had this done please get back to me if that some one is you;;;;;;;;;;;;;;;;;Have a nice pain free day I hope.

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on 03/05/2011 3:04am

snookers -

i had / have degenerative disc disease i was told , laminectomy L-4-5 / S-1 Fusion - cage / hardware /
6 peticle screws . pain was intense around fusion *after surgery . two years later , surgeon removed
the hardware , pedicle screws ... upon recomendations of three orthopedic opinions . two of the pedicle screws in place had partially backed out of the bone . *additional scar tissue is created by successive operations . it's alot of the reason of severe pain leftover in a major operation like this , i was told . i still have so many questions , either surgeons wont fully discuss , or can't answer . its been 10 years of living with this constant pain , limited walking , standing , laying down , lack of sleep , etc .
my answer to your question , *get another opinion , or two even . it's a very serious decesion . all of us who have had back surgery wish you the very best for success and comfort .

arlie

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on 04/14/2011 7:06pm

I have had the surgery and yes i have hip and lower pain since. yes it can happen i have mor e pain than i had before the surgery. Make sure you have a good surgeon. ive lost everything due to my inability to work.

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on 04/16/2011 4:48pm

First let me say, sorry about your situation........exactly why I am very leery of ever having any fusions done, even though I have DDD and discs out in both my low back and neck. Already have had two laminectomies and everything went fine, but that was many many years ago. As far as using bone grafts, this is not dark ages procedure.......I had it done with a shoulder problem and was warned that the hip would hurt more than the shoulder in recovery, but no big deal. Turned out fine with no residual pain. Hope you find relief.

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on 04/17/2011 5:21pm

Hi sorry to hear about what you are going through. I had fusion on my L5 S1 in March 2010. I had the bone marrow taken from my hip the dr just grew a bone instead of putting a plate in place of the disc. Since I had the surgery I am in no better shape than before. The only good thing surgery helped. I can now feel my legs. They do not hurt and the numbness is not there as bad as before. However, I am having a lot of pain can't walk for over 10-15 minutes without pain becoming very severe. If I sit for over 15 min when I stand the pain is unbearable. As for being able to bend over I can't at all. I have more problems out of the right side which the hardware is located and he did take the bone marrow from my right hip as well. So I can't really tell you what to expect other than you know how bad back surgery is. There will still be hardware even if they replace it with bone. Until that bone is fully fused they will not take the hardware out. That is the point I am at now. With all the pain I am having my Dr. wants to do a hardware block to see if it helps. If it does he wants to take the hardware out. If it doesn't help then he said a muscle was probley wrapped around the hardware. I wish you luck on whatever to decide.

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on 05/22/2011 8:30pm

Hi Snookers,

I'm in same situation as you. My last CT scan showed I am completely fused. My NS had originally told me I prolly would have to have the screws removed b/c I was thin. He has walked his 'guarantee' back a few times. I told him about some of the comments people have made here and his last response was thin people get more relief than heavier people. He did not say what 'heavy' means, but I'm assuming if you have any kind of hips or a bit of fat at the location of the screwheads, you probably would not have as much relief. I'm having my surgery next week but now I am reconsidering since I noticed I have not worked out as much as I did. As a result, I have gained a pound or two in that area so it is not easy to feel the screws.

I would suggest you try the hardware block or whatevr your NS suggested before agreeing to more surgery. I understand the surgery itself is easy and take about 45 mins. It is often done as out patient depending on your insurance. But one never knows the outcome and I should think you would want to be as certain as possible that the screws/hardware are the problem first. From what you write, it sounds like a much bigger surgery than what I am facing and I do know from other people hip grafting is painful in recovery. Have you had a CT scan to confirm you are completely fused? Could the hardware or a broken screw be causing your problem?

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on 05/25/2011 3:03am

dear shadding -

at 59 , i was told i had degenrative disk disease and needed a L4-5 , S-1 fusion / *with complete hardware - rods , plate , 6 screws / cage wrap put in . bone chips from hip used as well . in the beginning , severe chronic pain traveling down *left hip to foot , and across lower back . after 1st . surgery still severe pain in lower back / thru fusion area . pain down left leg went away . for two yrs . i tried everything *known to a pain specialist to find relief , but nothing worked .
finally , same surgeon did the 2nd. operation > *on advice of 3 new opinions that hardware should be removed . I was really hoping pain would be gone . But doctors now admit in most cases the patient can have residual chronic pain long afterwords , due to scar tissue . That having additional surgeries will not quarantee any less chronic pain ? Its still there every day . It definitely changes one's daily lifestyle . I asked about using a small amount of bone from my hip ? > but was told it wouldn't be any problem . I do think the chronic pain / post *scar - issue in this area of major Back surgery is a normal outcome from what you learn listening to others . Your seeing a *neurosurgeon is wisest by far for
you . Still good to have another opinion though . And do ask the doctor his success rate this type
surgery he recommends ? Good luck that it works out well for you .

A

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on 05/25/2011 9:07pm

Hi
I had a fusion at L5 S1 back in 92, 2 years later I had the hardware removed because of continued pain. The fusion I had was anterior and posterior meaning I was fused from the front and back, I had a large piece of bone removed from my hip and placed in the front of the spine, and smaller pieces removed from the rear together with the rods placed in the back of the spine. I do get pain and discomfort at the donor site, but it isn't prolonged usually after I have been sitting too long. My biggest problem with the graft site is when wearing underwear, as the elastic cuts right across this area making it very uncomfortable. My fusion was successful, though it took approx 3 years for everything to settle down. The thing with fusing one area is that it puts more pressure on the adjacent areas, which is now my problem. Removing the hardware was a turning point in my recovery and if your Dr thinks this is causing your problems, I would consider it, but nothing is a guarantee when dealing with back issues. Good luck.

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on 05/25/2011 9:16pm

Hi there:) I have had 4 back surgeries; the first one was my neck and I have a plate and screws covering the area from C2 through C4, the second one was my lumbar spine, the third one was removal of my coccyx and the last one was also the lumbar spine with damage to L3 through L5. I had removal of the disk material in 2 of the disks, which was replaced with bone morphogenic protein, which only partially regrafted. One of the surgeries required they remove bone from my hip. This was one of the most painful operations and and the slowest to heal. There are alternatives to taking the bone from a hip, which could be bone from a cadaver, or bone morphogenic protein. My recovery time with the bone from my hip was longer than the other surgeries I had, and still today I have discomfort in that area, although it is not unbearable. There is always the risk of infection also, but very slight. Overall, I would prefer not going this route again because of the discomfort, but that was my personal choice. However, in speaking with my orthopedic surgeon he said that he often tries to steer patients away from bone from the hip because of the discomfort and sometimes complications from this type of surgery. I hope this has helped you. I wish you all the very best!

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on 07/08/2011 8:11pm

I hate to tell you, but its painful when they take the bone from the hip. I just had my surgery on 4/26/2011 and my doctor took it from the iilac bone and also bone marrow to fill in for my spinal fusion. I was doing good the first 2 months, but when I move my right side its painful off and on, but my pain pills get me through it. I have had a spinal fusion on the L5S1 back in 1997 and the bone came from the hip and the pain was heavy and diddle for a year. I expect the same from this surgery. I start physical therapy July 26th and I hope they will work with my problems. My knees are starting to hurt, because I am favoring my right hip, which I need to stop doing that and start doing some exercises. I never heard it would cause problems with the hip. Its a long process for it to heal! I hope this helps you out.

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on 07/14/2011 7:04pm

I just had surgery to remove the hardware and I am almost free of pain in that area. I did find that it was not all of my problem however and that I may have problems in my SI joints because the pain I have left is in my hip area. But as for my back, it has improved 80 percent since I had the hardware removed.

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on 07/19/2011 6:49pm

Hi there. I had my first fusion in '89. At 18 yrs old. I then got into a car accident and had a 2nd fusion with instrumentation when I was 23. I also had a neck fusion at that time. I had to have my back redone because at the time of the accident there had been a non-union. About 7 years after the 2nd fusion I experienced problems with instrumentation and had as much of it removed as I could. That was the easiest surgery I'd had! I was back to work within 3 weeks and I felt great after it! I also had bone removed from both hips. Once for the back (L5-S1). And once for my neck (C6-c7). If you have already experienced the pain of the fusion I would say that this should be a walk in the park for you! I just found this forum because now I need to have another fusion done at L5-L4 because that disk is now almost gone and my spine has slipped forward. I still work full time and am very active. I think I handle it fairly well because I have experienced back pain my whole life. The benefit that you receive by staying active vs the pain caused by activity is a no brainer for me. Your body's own endorphins are better than any painkiller and the benefits, to me, outweigh the pain. Good luck!

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on 10/11/2011 11:49am

take bone from the hip??? Thats such an antiquated way to still do spine surgeries. I would recomment getting a second and third opinion ......from a Dr with current methods.
Even with all the technology today it's all a crap shoot. There are risks with every surgery. You get the hardware removed...it might work...it might not....it also might cause a whole nother set of problems. My PM Dr wants me to consider a Spinal Cord Stimulator implant. It MIGHT work. But can also cause a whole host of other problems like being paralyzed.
Good luck in whatever you choose to do!
best wishes

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on 11/17/2011 9:14pm

They would take out a bone from the iilac crest. It is painful for up to one year. I recently had surgery this past April and I thought the pain would never go away and it has and this is November. So go ahead and do the operation, the hip pain will subside later on...hope this helps

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