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Removing Instrumentation After Anterior Fusion?

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  • #1

    Removing Instrumentation After Anterior Fusion?

    I'm just curious if anyone here has had their instrumentation removed after having spinal fusion using an anterior approach. My daughter had anterior surgery, and they had to collapse a lung, and cut ribs to get to the front of her spine for fusion. One of my biggest fears is that she'll need the instrumentation removed, and we'll have to go through the whole gory ordeal in reverse. I'm hoping someone out there can reassure me.

    Thanks
    Susanna
    ~~~~~~
    Mother of a 17 year old daughter. Her "S" curve was 40 degree thoracic from T3 to T9, and a 70 degree rotatory thorcolumbar from T9 to L4. She was operated on March 9th, 2005 by Dr. Boachie-Adjei at the Hospital for Special Surgery in NYC. She was fused from T11 to L3, using an anterior approach, and the major curve corrected to 20 degrees. She's doing great!
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  • #2
    Hi Susannah....

    The most common reason for implant removal is pain from the implants. Since your daughter's implants are on the front of the spine, with no soft tissue rubbing over them, it's a lot less likely that they'd ever need to be removed.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

    Comment

    • #3
      Susanna & Linda,
      My daughter's surgery was very similar to your daughter's Susanna. There were a few things different, but for the most part reading what you wrote was like reading about Kate's (my daughter) surgery in 2003. When we had the 1st surgery we thought that was it, everything would be fixed. Unfortunately, Kate is scheduled for surgery to remove her hardware on 7/15/05.
      According to Kate's surgeon, one of the main reasons she is still in pain is that she is very thin and the rod is irritating her muscles and nerves. She had the anterior approach as well, but you can feel the lower left corner of her rod through her skin (which is what we believe is causing some of her pain).
      I'm sorry I'm not being too reassuring, but I guess I just feel, for my own part, that I would rather know the facts than to not. I had no idea when we went into the 1st surgery that there was a possibility of having to have the hardware removed for any reason.
      On the bright side, while not rare, Kate's situation is uncommon. Try not to let it bother you too much. Just keep an eye on your daughters recovery and watch for any chronic back pain that can't be explained.
      Good Luck!
      Kathy (Kate's Mom)

      Comment

      • #4
        Kathy...

        Katie's implants are on the front of her spine and you can feel them through her skin? I just can't even image how that's happening. Are you talking about feeling them through the skin on her back, her side, or her front? When you go to see the surgeon, would it be possible to take along a camera so that you can get a picture of the x-rays while they're up on the lightbox?

        Regards,
        Linda
        Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
        ---------------------------------------------------------------------------------------------------------------------------------------------------
        Surgery 2/10/93 A/P fusion T4-L3
        Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

        Comment

        • #5
          Linda,
          Kate's implants are in the front of her spine and you can feel the lower left hand portion of the rod. Her surgeon has felt it many times and is convinced that it is the rod. I have her pre and post op x-rays on my computer if you would like to see them I can send them via email.
          Thanks,
          Kathy

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          • #6
            Yes, I'd love to see them. Please send them to linda @ scoliosislinks.com (without the spaces).

            Thanks!

            --Linda
            Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
            ---------------------------------------------------------------------------------------------------------------------------------------------------
            Surgery 2/10/93 A/P fusion T4-L3
            Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

            Comment

            • #7
              Kathy & Linda,

              Thanks both of you for your messages. The good news here is that in my daughter's case, you can't feel any instrumentation from the outside, and my daughters is three months post-op and has really no pain or discomfort other than occasional achiness.

              Linda, I thought most times instrumentation was removed because the fusion failed and a rod broke or separated, or because of infection or allergy to instrumentation? We insisted on Titanium, because my family has a history of nickel allergies, and my daughter is already so allergic to many things, I was afraid of using steel. My doc said because her curve was quite flexible, that titanium was the best choice anyway. I know, however, it is more brittle, and therefore more likely to break...

              Another question, I have heard differing opinions on how long she will need prophylactic antibiotics when having dental work done. Again, she has Titanium instrumentation. Any opinions?
              Susanna
              ~~~~~~
              Mother of a 17 year old daughter. Her "S" curve was 40 degree thoracic from T3 to T9, and a 70 degree rotatory thorcolumbar from T9 to L4. She was operated on March 9th, 2005 by Dr. Boachie-Adjei at the Hospital for Special Surgery in NYC. She was fused from T11 to L3, using an anterior approach, and the major curve corrected to 20 degrees. She's doing great!

              Comment

              • #8
                Hi Susannah...

                I never even thought of the group you mentioned as the same thing. If a rod breaks, it's usually removed, but replaced. I think we were talking about just have implants removed because they're uncomfortable. I've even talked to one doctor who routinely schedules his patients for implant removal. (I would never recommend anyone going to him.)

                The use of prophylactic antibiotics with dental work is very controversial. The research shows that it doesn't make sense to put everyone with implants on prophylactic antibiotics. However, if patients ask about it, they're usually put on the antibiotic because the doctor doesn't want to take the risk of getting sued if the patient ends up with an infection. I personally have chosen not to take the antibiotics.

                Regards,
                Linda
                Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
                ---------------------------------------------------------------------------------------------------------------------------------------------------
                Surgery 2/10/93 A/P fusion T4-L3
                Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                Comment

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