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What does removal of the iliac screws involve?

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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 48
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
    Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
    Not "confused" anymore, but don't know how to change my username.

  • #2
    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

    Comment


    • #3
      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.

      Comment


      • #4
        Evelyn

        Sorry to hear about this pain.....I’m 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 63, the new 64...
        Pre surgery curves T70,L70
        ALIF/PSA 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

        Comment


        • #5
          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. --Twain
          ---------------------------------------------------------------------------------------------------------------------------------------------------
          Surgery 2/10/93 A/P fusion T4-L3
          Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

          Comment


          • #6
            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

            Comment


            • #7
              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.
              Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

              2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
              2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
              2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
              2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
              2018: Removal L4,5 screw
              2021: Removal T1 screw & rod

              Comment


              • #8
                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. --Twain
                ---------------------------------------------------------------------------------------------------------------------------------------------------
                Surgery 2/10/93 A/P fusion T4-L3
                Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                Comment


                • #9
                  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
                  Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                  2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                  2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                  2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
                  2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
                  2018: Removal L4,5 screw
                  2021: Removal T1 screw & rod

                  Comment


                  • #10
                    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. --Twain
                    ---------------------------------------------------------------------------------------------------------------------------------------------------
                    Surgery 2/10/93 A/P fusion T4-L3
                    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                    Comment


                    • #11
                      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, 01:49 AM.
                      Adult Onset Degen Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Sev disc degen T & L stenosis

                      2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 2 surgeries
                      2014: Hernia @ ALIF repaired; Emergency screw removal SCI T4,5 sec to PJK
                      2015: Rev Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
                      2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone
                      2018: Removal L4,5 screw
                      2021: Removal T1 screw & rod

                      Comment


                      • #12
                        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)

                        Comment


                        • #13
                          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!

                          Comment


                          • #14
                            Originally posted by dixiesmommie
                            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. --Twain
                            ---------------------------------------------------------------------------------------------------------------------------------------------------
                            Surgery 2/10/93 A/P fusion T4-L3
                            Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

                            Comment


                            • #15
                              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. --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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