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Thread: Removing screws and rods?

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  1. #1
    Join Date
    Aug 2004
    Location
    Gulf Coast, USA
    Posts
    22

    Removing screws and rods?

    I had my first scoliosis surgery in May 2002 at age 52. I am now contemplating having the screws removed, or rods and screws removed, depending on what is inside and how it looks.

    The screws are so painful, I'm about to go crazy. Right at the top of the rods, and right where the back bra strap crosses my back are the painful areas. My doctor says it's because I am "so thin". I could lose a good 20 pounds before I'd be "just right" - not to heavy, not too thin.

    My question is: has anyone else ever had just the screws removed? What about rod removal? Does the spine try to curve again? I've spoken to my doctor, but I'd like to hear from experienced patients. I'm told it's supposed to be fused completely, but I'm still concerned.

    I guess I'm just afraid my spine will add more curves. I still have three curves and will never be fully straight because of the degrees of my original curves before surgery and my age. I'm afraid the osteoporosis at the top will turn the upper spine to mush without the rods. And I do dread the thought of more cutting, especially since I caught a staph infection the first time around.

    Any thoughts?
    Sid Rid
    (female)

    Age 52
    Surgery May, 2002
    T4-S1
    MRSA staph infection

  2. #2
    Join Date
    Dec 2004
    Location
    Maine
    Posts
    2
    Hi Myrtle -
    I am new to this site and I saw that you haven't had any replies yet. I may not have any great information for you but at least can let you know about rod removal.

    I am currently 32 years old and I am still battling back pain issues. I was diagnosed with ideopathic scoliosis at age 7. At age 21, I had a spinal fusion (T5 through L2) with TSRH instrumentation in 1994. In 2001, I was suffering from repeated back spasms. The doc found that my rod was broken. I was in the same position as you as to whether I would have the rod removed. The doctor could not guarantee I would have no ill effects from the removal of the instrumentation. I decided to go ahead with the removal as I feared the broken rod would do further damage.

    I went in for surgery on a Friday morning and left the hospital on Monday. They would have discharged me on Saturday yet my B/P was too low and my drain was still filling up with fluid. I took four weeks off from work as I thought I needed the time to recouperate (although looking back I probably only needed a week off). The recovery process from this surgery was much less difficult for me than the initial fusion and rod placement.

    If you decide to have the surgery, the prognosis will probably depend on numerous factors. Given it has only been 2 1/2 years since your initial surgery I am not sure how well the fusion has healed.
    Did you have donor bone or did you use your own bone? I had my own bone fused and they say that is more sucessful.

    Do you smoke? Supposedly, fusions do not heal as well if you smoke.

    What kind of instumentation did they use? The TSRH instrumention that I had was diffucult to remove as the rod and hooks are all attached as one unit - they couldn't take just the rod out.

    I would make sure I found the BEST orthopeadic surgeon who specializes in this area before I went through another procedure.

    Footnote: I am now battling with 3 protruding discs below my fusion which they tell me is something I will have to deal with for the rest of my life (I wish I had known this before the elective fusion and rod placement at age 21)

    Sorry for the long message, but I hope it gave you a little insight.
    Sincerely, Steph H
    Last edited by shicks72; 12-31-2004 at 01:49 PM.
    Stephanie H.
    T5 - L2 fusion with TSRH instumention - May 1994
    instrumention removal - July 2001

  3. #3
    Join Date
    Dec 2004
    Location
    Kent ,England
    Posts
    5
    hi all , i know of a lady from another site who had her rod removed after it broke .Some years on now her back has got worse and she has also has badly degenerating discs .She has just been told by her Surgeon at Great Portland Str in London that they are going to operate again .They will smash up the existing fusion , straighten the spine and refuse and put rods in.She will be in hospital for about 6 weeks and have 3 operations .The surgeon said they might look into replacing the discs that are real bad but they wont know about that til after the Op .

  4. #4
    Join Date
    Dec 2004
    Location
    Maine
    Posts
    2
    Pikey -
    that makes me really sad
    I hope that happens in a small population of patients that are going through what we are.
    I will be thinking of her and hoping for the best for her....
    Stephanie H.
    T5 - L2 fusion with TSRH instumention - May 1994
    instrumention removal - July 2001

  5. #5
    Join Date
    Dec 2004
    Location
    Kent ,England
    Posts
    5
    dont be sad , i took her to the hospital because a few months before she chickened out. She is so happy that it is finally going to happen .Plus they reckon they can straighten her as well ,maybe i will be able to get her on to tell her story but if not i will let you know how it's going .Harrington rod patients are suffering but at least i know through "Smiler" that there is still hope ."Smiler " is the name of the lady aka "Jaquie".

  6. #6
    Join Date
    Sep 2004
    Location
    Dallas, Texas
    Posts
    82

    Re: Removing screws and rods?

    Myrtle:
    Like you, I had a staph infection the first go-around.
    So....I am afraid with the second operation looming close.
    In Michael neuwirths book, he says that most patients are
    not aware of the fact that the fusion which was done is the
    most important part of the operation. The rods are only to
    hold the back in place until the fusion takes hold; after that,
    they are simply left in. The fusion is the procedure which
    holds your spine in place. A consultation with your surgeon about the possibility of your back curving in areas not yet fused
    is in order.
    It feels strange telling you to hang on everything will be
    okay when I am petrified of my own upcoming operation and
    the memories of infection .But thats all we have. I wish
    you good luck and talk to your doc about culturing your back
    in the area where you had the infection. My doc will culture just before before he enters the back in the same area as the previous infection. There is only a small chace there will be spores left, but its a favor to the patient. Kathleen

  7. #7
    Join Date
    Sep 2004
    Location
    Dallas, Texas
    Posts
    82

    Re: Removing screws and rods?

    Myrtle:
    Like you, I had a staph infection the first go-around.
    So....I am afraid with the second operation looming close.
    In Michael neuwirths book, he says that most patients are
    not aware of the fact that the fusion which was done is the
    most important part of the operation. The rods are only to
    hold the back in place until the fusion takes hold; after that,
    they are simply left in. The fusion is the procedure which
    holds your spine in place. A consultation with your surgeon about the possibility of your back curving in areas not yet fused
    is in order.
    It feels strange telling you to hang on everything will be
    okay when I am petrified of my own upcoming operation and
    the memories of infection .But thats all we have. I wish
    you good luck and talk to your doc about culturing your back
    in the area where you had the infection. My doc will culture just before before he enters the back in the same area as the previous infection. There is only a small chace there will be spores left, but its a favor to the patient. Kathleen

  8. #8
    Join Date
    Sep 2004
    Location
    Dallas, Texas
    Posts
    82

    Re: Removing screws and rods?

    Myrtle:
    Like you, I had a staph infection the first go-around.
    So....I am afraid with the second operation looming close.
    In Michael neuwirths book, he says that most patients are
    not aware of the fact that the fusion which was done is the
    most important part of the operation. The rods are only to
    hold the back in place until the fusion takes hold; after that,
    they are simply left in. The fusion is the procedure which
    holds your spine in place. A consultation with your surgeon about the possibility of your back curving in areas not yet fused
    is in order.
    It feels strange telling you to hang on everything will be
    okay when I am petrified of my own upcoming operation and
    the memories of infection .But thats all we have. I wish
    you good luck and talk to your doc about culturing your back
    in the area where you had the infection. My doc will culture just before before he enters the back in the same area as the previous infection. There is only a small chace there will be spores left, but its a favor to the patient. Kathleen

  9. #9
    Join Date
    Jan 2005
    Location
    PA
    Posts
    3
    Myrtle,

    Hi I am Bunnie and I read your post that was suggested by another on this site. I see you have had a staff infection. My daughter had a staff infection and all they did was try to lance it and use antibiotics locally. We were told that the infection would not go away unless the hardware was removed. What happened to you and your infection. What did they do for you to get rid of it? My daughter had her second surgery to remove the rods and now after almost 2 years now has curved again after the doctor said she was fused and would not curve anymore. We are very upset that she will have a third surgery to put hardware back in. She has been pretty strong about all this even though I have not been. She actually keeps he up because she is. We even asked when we saw an x-ray several months after at a checkup that it looked like she had curved and was told she did not. We are not blind. Since the insurance changed and we had to get another doctor it took forever to get her records to even start with a new doctor. Since you are 52 I would think you would not curve again since your growth is over but I did see something on another site but just can't seem to find it now that said you can still curve around 1 degree each year after growth is over. If I find it I will send it to you. My daughter was told mis-information about her curving again and look where we are today. I hope all goes well with you and if you can give me that information on the staff infection I would appreciate it. Thanks.

  10. #10
    Join Date
    Aug 2004
    Location
    Gulf Coast, USA
    Posts
    22
    Thanks for your replies.

    Yes, I know that the rods are just "there" after the spine has fused. My fusion looks pretty cool on an X-ray, like a board. I am worried because I also have osteoporosis in the upper spine. The doctor didn't know it was there until she cut into me. The bone density tests don't tell the truth because they don't scan high enough.

    Bunnie, I received your email and responded today. For the others who are curious, my MRSA staph infection hasn't shown it's ugly head in nearly 2 and 1/2 years. My blood work comes back negative so I no longer have to take the oral antibiotics they told me I'd have to be on FOREVER because the rods were there to stay.

    I was treated with oral antibiotics for about 18 months, and IV antibiotics for 8 weeks. It was no picnic. I must say that it did have one positive effect. It killed all the body hair off me for quite awhile and I didn't have to shave my legs for one year and now only do so sporadically. Hair under my arms never did grow back. The hair on my head was okay although it was a bit icky for awhile. I like my hair soft and flyaway, but for a time it was stiff and in sad need of conditioner. It took ages for me to get it back to normal, now it's back to its soft flyaway self. My hair has always been thick, so I guess that's why I didn't notice any hair loss.

    All these stories about people having problems with discs and broken rods is quite scary.

    I'm sure no other surgery would be as traumatic on the body as the initial rod insertions, so I'm not in fear of removal itself. I'm just hoping nothing else goes wrong with it. Thanks for telling me about the infection site culture before any additional surgery. That's a very good idea.

    I have an appointment with my doctor next week, so I'll discuss it all with her then. It's not definite I'll have surgery anytime soon. She does have to check my cervical spine (neck). I have degenerative disease there are she keeps track of it because I may need surgery there someday, too.

    Thanks for your concern and I hope Bunnie's daughter and everyone else has quick healing.

    I will not be jumping into surgery before additional tests are run and everything looks okay.

    Just for the record, no, I've never smoked. I had bone grafting from a 'donor' because my bones are too small and in bad shape to use.

    Thanks for all the responses.
    Sid Rid
    (female)

    Age 52
    Surgery May, 2002
    T4-S1
    MRSA staph infection

  11. #11
    Join Date
    Jan 2005
    Location
    PA
    Posts
    12

    Bunnie did not get your email.

    Myrtle,
    Hi, I did not get your email. The email address has zeros in it and not the letter o's. Please send it again. Thanks.
    Bunnie

  12. #12
    Join Date
    Sep 2003
    Location
    NJ
    Posts
    1,291

    hardware removal

    I had an uninstrumented fusion in 1956 at age 14. Over my lifetime that "solid" fusion re-curved until by age 59 I had an 80 deg thoracic curve needing revision. I do not have osteoporosis, never smoked and am very active. I never had an infection.

    Recently, at my check-up, I told Dr. Boachie I was afraid of losing the correction we got 2 years ago (because of what happened to my original correction). He told me it's rare unless something happens to the hardware. I also asked another doctor at HSS the same question; he gave the same answer.

    In doing some research of the literature it mentions that many hardware failures are from poor bone quality where it becomes loose. Before hardware was used a person did not walk for a year while the fusion healed and wore a series of 3 casts. That was what I did. I had to learn to walk again. Instrumentation allows early ambulation and serves to support the spine during healing and reinforces the fusion permanently.

    I personally would not have mine removed unless they were going to replace it with something else.
    Original scoliosis surgery 1956 T-4 to L-2 ~100 degree thoracic (triple)curves at age 14. NO hardware-lost correction.
    Anterior/posterior revision T-4 to Sacrum in 2002, age 60, by Dr. Boachie-Adjei @Hospital for Special Surgery, NY = 50% correction

  13. #13
    Join Date
    Jan 2005
    Location
    Kansas City, MO
    Posts
    67

    No idea

    what a long way they've come with correction surgery. I didn't know that's how surgery used to be done. Were you flat on your back for a whole year in a cast? It makes me feel fortunate for what I will be facing for my first surgery.
    Tiny

  14. #14
    Join Date
    Jun 2004
    Location
    Ireland
    Posts
    35
    I agree with karen.Like her I had an uninstrumented fusion in 1983.My curve was 110 degrees and was not corrected.It seems to have progressed at a rate of up to a degree a year and I am debating revision surgery.My last consultant told me that larger fused curves without instrumentation i.e. those over 60 degrees tended to progress slowly,even after fusion . I also know the lady Pikey was referring to and in that situation it was a long c curve and the apex of the curve acted as a lever and allowed the curve to progress after the rod had been removed.As predicted the fusion was not solid, which may have explained why the rod broke.
    Sins

  15. #15
    Join Date
    Aug 2004
    Location
    Gulf Coast, USA
    Posts
    22
    Thanks for all the responses.

    Yes, one year in a cast was standard in the 1940s, '50s and '60s. That's why I opted not to have surgery in my teens, in the mid-1960s. There's an old book (1970s) by Rosalie Greisse, "The Crooked Made Straight" telling of her first surgery in the 1940s (they put her in a special hospital for a year!) through her seventh surgery in the 1970s. Makes you grateful for the medical improvements of today.

    I had to reschedule my doctor's appointment for next week because my dad is having some medical problems that call for more immediate attention. So my new appointment is in mid-February.
    Sid Rid
    (female)

    Age 52
    Surgery May, 2002
    T4-S1
    MRSA staph infection

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