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Pedicle Screw Pain & How to distinguish it...

Started by Kristine Coxon Ewing on 02/16/2017 5:42pm

Hello. My name is Kris. I'm a 50 y/o houeswife. I had a L5/S1 fusion in Oct.2015. As the surgery did help with pain associated with leg pain and numbness, there has been ongoing pain around the insicion site since then. It has been a frustrating last year. I've since had three injections with no avail. I had a spinal chord stimulator placed and removed due to complications and infection. I am now scheduled to see a Neurosurgeon out of USC later this month. He specializes in more complex spinal issues. I have heard mentioned that the pain, "could be" from the spinal hardware, yet there is not a definitive means to gauge that. It really seems hit or miss if that that would be the underlying issue. I do not want to go into another surgery with the mindset that having it removed would be the ticket. Because back pain is not that clear cut. I have had three MRI's since my surgery. I continue to be plagued by increased small central disc extrusion at L3-4. I have DDD, modest changes in the C-spine @ C5-6 & C6-7. Mild scoliosis, Osteoarthritis, Fibro, Sjogren's syndrome, and so forth. I am in pain management and take 3-4 Norco 10/325 in a 24/hr period. I am active but nothing too rigorous that exasperates my back even further. When I walk, there is a pretty contstant dull stabbing pain to my right side of insicion area, about 1/4 inch straight into my back. I am not sure if the pedicle screws are correctly paced into the sacrum. I essentially have no idea! Lol.
My question to anyone, "Have you experienced anything like this/ how does one decipher where the pain source originates from?" Any input would be awesome. Thank you in advance. Kris

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Hello, Kris--thanks for posting your questions! We're sorry to hear you're still dealing with pain after your spinal fusion.

In terms of finding out the source of pain, doctors use a variety of tools. Imaging scans (like MRI, x-ray, or CT scans) would be able to show things like herniated discs or instrumentation failure, as you mentioned. Diagnostic nerve blocks can also give your doctor clues about the origin of your pain. Of course, a physician's ears are among the best diagnostic tools--just listening to you describe your pain can be extremely valuable. On that note, we thought this article might be of interest to you ( Questions You Should Ask About Pain and Pain Treatment ).

Back to your inquiry about instrumentation failure: Unfortunately, this does happen. If screws or any other implanted device breaks or is positioned improperly, a second surgery may be necessary to remove and/or replace it. We see you mentioned already having three postop MRIs, but your neurosurgeon should be able to determine if this is the case using imaging scans.

We wish you the best of luck with your upcoming visit with your neurosurgeon!

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Hello! and Thank you for your response. I had a CT scan a few days ago to help see more clearly the placement of the pedicule screws. I see the Doctor again next week. It shall be interesting to see what he has to say. Kris

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I had many things done to my back when I had surgery in 2009. I did have a fusion and had rods and screws put in my back to stabilize my spine so the fusion could heal. My back surgery did stop the severe burning in the front of both thighs, but made my back and hips (both) pain worse. My surgeon took me when everything healed if needed I could have the hardware. But my surgery when back to Tx and he was an orthrosurgeon. I have seen two neurosurgeon within the last two years say they did not see enough healing and I just think they do not want to take it out because they did not put the pins and screws in. Because I had the surgery in early of 2009 and if it is not healed by now something is wrong. It is common for people who have had fusion to get bulging and herniated disc about and below infusion area. I am fused from L-4 to S-2.. 3 years after my surgery I could not take it anymore due to lower back pain, hips and both thigh pain had became so severe I had to start going to a pain management doctor for strong pain meds and became disable. I have always took the pain doctor that my hips and legs hurt worse than my back. He had done an epidural at L-4 L-5 but it did not help and I did have it again. Then in dec of 2015 I started has pain in my in buttock right where the pressure is when you sit and it finally got so pain I took the pain MD about it and he want to do a sterol epidural in S-1 and S-2.. I have had

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