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Thread: What does removal of the iliac screws involve?

  1. #1
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    What does removal of the iliac screws involve?

    Hi all,

    I'm coming up on 2-years postop in March. I am doing well, generally.

    However, I still have trouble tolerating the iliac screw on my left side, especially when I exercise.

    What does removal entail? Is it a big operation? Are you in the hospital long? Do they remove both, or just the one bothering you?

    Also, if you get these anchors removed, do you have a higher risk of fracturing the SI joint later? (Assuming my spine is fused.)

    Just not sure it is worth the risks/recovery, but at the same time I would like to be able to exercise without pain.

    Thanks,
    Evelyn
    age 41
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke, T4 to S1 with pelvic fixation
    Not "confused" anymore, but don't know how to change my username.

  2. #2
    Join Date
    May 2009
    Posts
    3,637
    hi Ev
    hope you and family are well...

    i thought you might want to contact
    Anne..."admoul" is her forum name...
    she had full length fusion with
    Dr. Lonner in Manhattan a few years ago...
    and had the screws removed a couple years
    after her surgery....she said she was
    doing well.
    i am sure you could type in "admoul"
    and write and ask her...

    wishing you the best 2014
    jess...and Sparky

  3. #3
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    New Bern, NC
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    Evelyn,
    I asked Dr. Hey about removal of my iliac screws because I have a lot of pain in that area and he wasn't too keen on that in my case because he felt that although my fusion is solid, it isn't really thick and was afraid it might fracture. I would ask your doctor for his opinion regarding the thickness of your fusion and if he thinks you would be safe if the iliac screws were to be removed. I plan on getting a second opinion from Dr. Rand sometime in May. I sometimes can't stand the pain. I can't take anti-inflamatories because they were damaging my kidneys and my latest blood test shows that my kidney function has returned to normal after two years. Nothing else seems to help my pain. Good luck Evelyn.
    Sally
    Diagnosed with severe lumbar scoliosis at age 65.
    Posterior Fusion L2-S1 on 12/4/2007. age 67
    Anterior Fusion L3-L4,L4-L5,L5-S1 on 12/19/2007
    Additional bone removed to decompress right side of L3-L4 & L4-L5 on 4/19/2010
    New England Baptist Hospital, Boston, MA
    Dr. Frank F. Rands735.photobucket.com/albums/ww360/butterflyfive/

    "In God We Trust" Happy moments, praise God. Difficult moments, seek God. Quiet moments, worship God. Painful moments, trust God. Every moment, thank God.

  4. #4
    Join Date
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    reno,nevada
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    Evelyn

    Sorry to hear about this pain.....Iím wondering what kind of exercise your talking about? Does this flair upon 60 seconds of walking? Or does it take a mile to get it to produce pain?

    It seems that we have to think 3 times before making our surgical decisions, and 6 times before our revision decisions.

    How is the back otherwise?

    Ed
    49 yr old male, now 55, the new 45...
    Pre surgery curves C12,T70,L70
    A/P T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  5. #5
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    Northern California
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    Well, I haven't had my iliac screw removed, but I've talked to a lot of people who have. For the most part, people tell me it's an easy surgery, with a very short recovery time. Some patients have it done as an out patient procedure.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  6. #6
    Join Date
    Aug 2009
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    St. Louis Missouri
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    I have similar problem

    I have similar pain. Ever since my 2006 revision (was T4-L4 from 1969-2006). 2006 - current is T3-Sacrum. Have never been able to sit without pain. I also blame the Iliac Screws, but not sure. Most pain is on my right side, however, mid section and left side also give me pain.

    They tried to give me Epidural Injections next to Iliac Screws, but they were unable to penetrate the fusion.

    Still don't have enough data to go for any hardware removal.

    If anyone has more info, please share.

    Thanks,
    Daily Pain
    58 Years old
    T3-Sacrum

  7. #7
    Join Date
    Jan 2012
    Location
    Yacolt, WA
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    So, how do you REALLY know what is causing your pain?

    Thanks for this discussion thread for pain that ??? Might be caused by pelvic screws. I am almost 1 year out and feel like there is a 2 by 4 stapled to my butt and is pushing me forward. I talked with my spine surgeon who blamed "pelvic screws".

    I am interested in possible non-surgical interventions that are not NSAIDS. Has anyone had the same sensation and had pelvic screws removed and had discomfort relief as described above?
    Anyone have another suggestion for the cause of the sensation?
    Suggestions for non-surgical treatment?

    Thanks. Susan

    Not sure that I would want to have pelvic screws removed with the level of pain that I currently have....but who knows about the future.
    2011: Degenerative Adult Onset Scoliosis @65
    25* T levoscoliosis/ 36* L dexroscoliosis w/ 11.2 cm coronal & 3.5 cm sagittal balance T kyphosis 90*
    Severe disc degen thoracic & lumbar stenosis
    Surgery: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    3/2013, Dr. Hu @ UCSF
    Postop hernia @ ALIF incision repaired 2014
    8/2014: Rev surgery OHSU Dr. Hiratzka hardware removal T3-T5; reinstrument & revision fusion T3-T6
    Proximal Junctional Failure w/ SCI
    Cauda Equina Syndrome

  8. #8
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    Quote Originally Posted by dailypain View Post
    I have similar pain. Ever since my 2006 revision (was T4-L4 from 1969-2006). 2006 - current is T3-Sacrum. Have never been able to sit without pain. I also blame the Iliac Screws, but not sure. Most pain is on my right side, however, mid section and left side also give me pain.

    They tried to give me Epidural Injections next to Iliac Screws, but they were unable to penetrate the fusion.

    Still don't have enough data to go for any hardware removal.

    If anyone has more info, please share.

    Thanks,
    Daily Pain
    58 Years old
    T3-Sacrum
    Hi Daily Pain...

    The ilium is not fused to the spine, so it's confusing to me why they'd be hitting fusion mass. I wonder if they were trying for the sacrum. Here's a photo of typical iliac screws:

    http://www.scoliosisjournal.com/content/6/1/6/figure/F1

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  9. #9
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    Quote Originally Posted by LindaRacine View Post
    Hi Daily Pain...

    The ilium is not fused to the spine, so it's confusing to me why they'd be hitting fusion mass. I wonder if they were trying for the sacrum. Here's a photo of typical iliac screws:

    http://www.scoliosisjournal.com/content/6/1/6/figure/F1

    --Linda
    Thanks for the pictures, Linda. Call me confused. Maybe I am not clear about my pelvic anatomy, but in another thread, I thought that you said that screws used in pelvic fixation are placed between the sacrum across SI joint and into the pelvis. From the picture above, it appears that the screws do not go through the SI joint. Where am I confused about this? Thanks, Susan
    2011: Degenerative Adult Onset Scoliosis @65
    25* T levoscoliosis/ 36* L dexroscoliosis w/ 11.2 cm coronal & 3.5 cm sagittal balance T kyphosis 90*
    Severe disc degen thoracic & lumbar stenosis
    Surgery: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    3/2013, Dr. Hu @ UCSF
    Postop hernia @ ALIF incision repaired 2014
    8/2014: Rev surgery OHSU Dr. Hiratzka hardware removal T3-T5; reinstrument & revision fusion T3-T6
    Proximal Junctional Failure w/ SCI
    Cauda Equina Syndrome

  10. #10
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    Quote Originally Posted by susancook View Post
    Thanks for the pictures, Linda. Call me confused. Maybe I am not clear about my pelvic anatomy, but in another thread, I thought that you said that screws used in pelvic fixation are placed between the sacrum across SI joint and into the pelvis. From the picture above, it appears that the screws do not go through the SI joint. Where am I confused about this? Thanks, Susan
    The screws can start just about anywhere. The point is that they're there for stabilization only and do not involve fusion. Here are a few examples:

    Example 1
    Note that there is haloing around both of these iliac screws

    Example 2
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  11. #11
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    Quote Originally Posted by LindaRacine View Post
    The screws can start just about anywhere. The point is that they're there for stabilization only and do not involve fusion. Here are a few examples:

    Example 1
    Note that there is haloing around both of these iliac screws

    Example 2
    So, question: Do screws go through the SI joint usually? I understand that screws are not a part of the fusion. Susan. Cool haloing. Great picture. Now, where are my X-rays and I will check them out!
    Last edited by susancook; 02-28-2014 at 01:49 AM.
    2011: Degenerative Adult Onset Scoliosis @65
    25* T levoscoliosis/ 36* L dexroscoliosis w/ 11.2 cm coronal & 3.5 cm sagittal balance T kyphosis 90*
    Severe disc degen thoracic & lumbar stenosis
    Surgery: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
    3/2013, Dr. Hu @ UCSF
    Postop hernia @ ALIF incision repaired 2014
    8/2014: Rev surgery OHSU Dr. Hiratzka hardware removal T3-T5; reinstrument & revision fusion T3-T6
    Proximal Junctional Failure w/ SCI
    Cauda Equina Syndrome

  12. #12
    Join Date
    Aug 2009
    Location
    St. Louis Missouri
    Posts
    21

    Thumbs up Reply to Susan regarding 2x4 pain

    Oh my gosh. I use that term almost everyday. "Feels like I have a 2x4 right at the end of my scar on my pelvis or sacrum area.

    Most times I say I can't bend over (which means very little bend over since I can't bend-more of a lean forward), because my 2x4 feels like it might crack. So my husband does whatever it was I needed for me. He does so much, I feel bad. He does almost everything around the house and other.

    I think we do have something in common. We may be on to something.

    Daily Pain
    (Karen)

  13. #13
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    Quote Originally Posted by susancook View Post
    So, question: Do screws go through the SI joint usually? I understand that screws are not a part of the fusion. Susan. Cool haloing. Great picture. Now, where are my X-rays and I will check them out!
    Susan,
    I think "haloing" is a bad thing. I'm pretty sure it means the screws are loose, otherwise there would not be room "halo" around them.

    On the spine model it didn't look to me like the screws went through the SI joints, but on the x-rays of the real people it did. Good question.
    Be happy!
    We don't know what tomorrow brings,
    but we are alive today!

  14. #14
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    Quote Originally Posted by dixiesmommie View Post
    Linda,

    I am going for my 6 month post op on Wednesday. Is there anything i should be asking? I am having severe pain behind the previously harvested bone area where I think my screw is. Sitting is still unbearable.

    Thanks
    At 6 months, if your pain is really intense, I'd want to start hearing about might be causing the various pains.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  15. #15
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    Quote Originally Posted by susancook View Post
    So, question: Do screws go through the SI joint usually? I understand that screws are not a part of the fusion. Susan. Cool haloing. Great picture. Now, where are my X-rays and I will check them out!
    There is no usual.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

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