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Hardware removal

Started by 100002077986103... on 09/14/2011 11:34pm

Had burst compression # L1 Jan,2011. Surgical instrumentation 2 rods, 4 screws T12-L2 without fusion. Initial plan was to remove hardware
after 1 year to restore range of motion. Xrays look great but surgeon now sounds unsure about removing hardware. What are the pros and cons. Would like it removed but not if it could potentially worsen my symptoms. What are the risks of leaving them in (unfused) I'm feeling quite unsure what to do.

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1 Response



It sounds as if your surgeon took a good approach to your problem. This is being done more commonly and is often the way that I approach these problems. In general, when I consider removing the hardware, I would want took carefully look at imaging studies to assess the healing of the bones. You may want to ask you surgeon about the concerns that he or she may have about the bone healing.

When I do remove the hardware, I remove the rods first. Then using fluoroscopy in the OR, there are things that can be done to assess stability before the screws are removed. If there is any concern the rods can be re-inserted and a fusion done at that time. If the spine appears stable then everything can be removed.

Leaving the rods as they are is an option. Your bones may still have fused, even without the surgeon doing a "fusion" operation. If the bones are not fused, then the instrumentation may loosen in the bone or break in the future. This doesn't necessarily mean that something bad will happen to you when or if this does, but this should be followed closely.

Hopefully this helps.

Best Regards,

J Brad Bellotte
Chief of Neurosurgery
UPMC Hamot Medical Center
Erie, PA

Clinical Assistant Professor of Neurosurgery
University of Pittsburgh School of Medicine