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Thread: How do rods break?

  1. #16
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    Ed you are so funny😆
    T10-pelvis fusion 12/08
    Fractured t-9 six days out of surgery
    C5,6,7 fusion 9/10
    PJK at t-9
    T2--T10 fusion 2/11
    Removal of left side t6-t10. 8/14
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16

  2. #17
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    Ok, so I guess I need to get straight on terminology. If you have a 2-part procedure where they start with an anterior incision and finish with posterior, that is correctly abbreviated ALIF/PSF, rather than what I wrote? And what, then, is PLIF?

    And if all circumferential fusions have low incidence of pseudarthrosis (pseudoarthrosis is wrong?), then are the non-unions and broken rods occurring in people with non-circumferential fusions or just in people with bad luck, or is some other factor involved? Or do we even know?
    Stephanie, age 56
    Diagnosed age 8
    Milwaukee brace 9 years, no further treatment, symptom free and clueless until my 40s that curves could progress.
    Thoracolumbar curve 39 degrees at age 17
    Now somewhere around 58 degrees thoracic, 70 degrees thoracolumbar
    Surgeon Dr. Michael S. O'Brien, Baylor's Southwest Scoliosis Center, Dallas TX
    Bilateral laminectomies at L3 to L4, L4 to L5 and L5 to S1 on April 4, 2012
    Foramenotomies L3 through S1 in August 2014

  3. #18
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    Quote Originally Posted by Mojo's Mom View Post
    Ok, so I guess I need to get straight on terminology. If you have a 2-part procedure where they start with an anterior incision and finish with posterior, that is correctly abbreviated ALIF/PSF, rather than what I wrote? And what, then, is PLIF?
    [QUOTE=Mojo's Mom;165844]Yes, that's correct. I think PLIFs are relatively rare these days. I don't think I've seen one done at UCSF during my 7 years there.

    Here are links to animations of the two procedures.

    PLIF
    TLIF


    Quote Originally Posted by Mojo's Mom View Post

    And if all circumferential fusions have low incidence of pseudarthrosis (pseudoarthrosis is wrong?), then are the non-unions and broken rods occurring in people with non-circumferential fusions or just in people with bad luck, or is some other factor involved? Or do we even know?
    I couldn't find a study (though I'm sure one exists) to compare the two cohorts. I'm certain that circumferential fusions have a much lower pseudarthrosis rate than posterior only fusions, but I can't give you the numbers. I'm sure it's largely dependent on things like age, bone quality, smoking status, etc.

    I've actually seen both pseudarthrosis and pseudoarthrosis in the literature, but it's usually pronounced sued-arth-ro-sis.
    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
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    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
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  4. #19
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    Wink Broken Hardware and non-fusion L5-S1

    In June of 2016 I was using my body force pushing myself down to reach below where I could physically reach and heard a really LOUD pop. It smarted a bit but the actual pain didn't come until a few hours later and has gradually gotten worse. Fast forward to this past Thursday, I had an appointment with a neurosurgeon at Wake Forest Baptist Health who will surgically correct my broken titanium rod and non-fusion and will replace the loose "thingy" like a metal spacer but not a spacer inbetween L5-S1. It is nice to be here amongst people who have the same body type and have lived very similar lives. I will post my history later and there are some that I think I know from different forums. The surgeon's scheduler will call me with a surgery date. The surgeon does these procedures with the assist of a vascular surgeon who goes in first to move everything out of the way and then back in place afterwards. This will be done from the anterior side. I'm guessing I'll be more sore from the incision through the belly than from the actual procedure. They said the hospital stay would be anywhere from 1 1/2 to 3 days, depending on how I'm doing. How did ya'll do in the recovery department?

    LindaG

  5. #20
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    Quote Originally Posted by Spine View Post
    In June of 2016 I was using my body force pushing myself down to reach below where I could physically reach and heard a really LOUD pop. It smarted a bit but the actual pain didn't come until a few hours later and has gradually gotten worse. Fast forward to this past Thursday, I had an appointment with a neurosurgeon at Wake Forest Baptist Health who will surgically correct my broken titanium rod and non-fusion and will replace the loose "thingy" like a metal spacer but not a spacer inbetween L5-S1. It is nice to be here amongst people who have the same body type and have lived very similar lives. I will post my history later and there are some that I think I know from different forums. The surgeon's scheduler will call me with a surgery date. The surgeon does these procedures with the assist of a vascular surgeon who goes in first to move everything out of the way and then back in place afterwards. This will be done from the anterior side. I'm guessing I'll be more sore from the incision through the belly than from the actual procedure. They said the hospital stay would be anywhere from 1 1/2 to 3 days, depending on how I'm doing. How did ya'll do in the recovery department?

    LindaG
    Hi LindaG - I feel like I can answer this one! Right up my alley. I am 5 weeks post-op, back at work, off the pain meds, but still having a lot a pain. Although not broken rod pain, just surgical pain. The advice everyone gave me here was "get 'er done." Which helped me feel right about having the revision surgery. Best of luck!
    Surgery June 18 by Dr. Errico at NYU Hospital for Joint Diseases at age 41.
    Fused T10-Pelvis.
    "Ask me about my brand new lordosis!"

  6. #21
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    Quote Originally Posted by Spine View Post
    In June of 2016 I was using my body force pushing myself down to reach below where I could physically reach and heard a really LOUD pop. It smarted a bit but the actual pain didn't come until a few hours later and has gradually gotten worse. Fast forward to this past Thursday, I had an appointment with a neurosurgeon at Wake Forest Baptist Health who will surgically correct my broken titanium rod and non-fusion and will replace the loose "thingy" like a metal spacer but not a spacer inbetween L5-S1. It is nice to be here amongst people who have the same body type and have lived very similar lives. I will post my history later and there are some that I think I know from different forums. The surgeon's scheduler will call me with a surgery date. The surgeon does these procedures with the assist of a vascular surgeon who goes in first to move everything out of the way and then back in place afterwards. This will be done from the anterior side. I'm guessing I'll be more sore from the incision through the belly than from the actual procedure. They said the hospital stay would be anywhere from 1 1/2 to 3 days, depending on how I'm doing. How did ya'll do in the recovery department?

    LindaG
    Most anterior surgeries are now done by splitting the muscle as opposed to cutting the muscle. When I had A/P surgery 5 years ago, I essentially had no anterior pain.

    --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.

  7. #22
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    Hi baroness, thanks for your response. It's good to know that at least the broken hardware pain will subside (or did for you) soon after the repair. I haven't worked since 2005 so I won't have the added pressure of needing to get up and at'm if I'm not up to it. I sure hope you continue to recover so your pain will subside!


    Hello Linda Racine, I'm really glad to hear about the muscle being divided and not cut. Seems like I heard the surgeon mention something like that. By the time I saw him, I had been through so many tests with no findings of anything like broken hardware or anything causing this additional hell on earth pain and then when it was identified, it was a rough go of finding a surgeon who would even see me in an appointment, that when I finally saw this surgeon after a 5 month wait, I was so dumbfounded that he was so very familiar with the Harrington rod generation and plain & simply explained my situation and how he'd fix it, I just couldn't think of any questions and had trouble comprehending everything he said. But I COULD tell he was a pro, he and his staff, very much unlike my last experience 10 years ago, plus the fact that this is Wake Forest Baptist Health. But I will find out for sure if the vascular surgeon does that instead of cutting, it will give me that much more to look forward to in getting better faster.

    Thanks all!
    LindaG

  8. #23
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    Quote Originally Posted by Spine View Post
    In June of 2016 I was using my body force pushing myself down to reach below where I could physically reach and heard a really LOUD pop. It smarted a bit but the actual pain didn't come until a few hours later and has gradually gotten worse. Fast forward to this past Thursday, I had an appointment with a neurosurgeon at Wake Forest Baptist Health who will surgically correct my broken titanium rod and non-fusion and will replace the loose "thingy" like a metal spacer but not a spacer inbetween L5-S1. It is nice to be here amongst people who have the same body type and have lived very similar lives. I will post my history later and there are some that I think I know from different forums. The surgeon's scheduler will call me with a surgery date. The surgeon does these procedures with the assist of a vascular surgeon who goes in first to move everything out of the way and then back in place afterwards. This will be done from the anterior side. I'm guessing I'll be more sore from the incision through the belly than from the actual procedure. They said the hospital stay would be anywhere from 1 1/2 to 3 days, depending on how I'm doing. How did ya'll do in the recovery department?

    LindaG
    Hi. I had A/P surgery June 2016 and I was very nervous about the abdominal incision. Much to my surprise, I had no pain, or very little pain, in my abdominal incision. Having said that, I was on heavy narcotics for 2 weeks to where I don't remember much, so maybe I had pain and just didn't know it. But, by the time I was "with it" I don't recall any incision pain. I had lots of pain, but it was mostly muscle / soft tissue pain in my back that takes so much time to heal. My abdomen was fine.

    Kathy
    Decompression surgery L4/L5
    April 3, 2015
    Twin Cities Spine Center - Dr. Joseph Perra
    Fused from T11 - Sacrum anterior/posterior
    June 24, 2016 - 55 years old at surgery
    Twin Cities Spine Center - Dr. Joseph Perra
    Before Surgery: 42 degrees lumbar, 28 degrees thoracic
    After Surgery: 10 degrees lumbar, ?? Thoracic
    2 inches taller

  9. #24
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    May 2010
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    I am one that has had several revision surgeries because I didn't fuse.I had my share of falls too. But Dr. Lenke and Dr. Gupta always say it's the non- fusing that breaks the rods!! I don't know why , but my lower spine( L3/4 4/5) are very hard to fuse. I don't know what I will do if this last surgery doesn't fuse. It has been almost five months. I can't just keep having surgeries. It's too hard on my body. But so is being bent over. I have a lot of pain, but I have issues with fibromyalgia. My iliac rods are painful. And the rods in my neck hurt a lot. Just a grinding pain!!! I guess we have to hold each other up. This is the only place that has any idea what these surgeries are like. Praying for lots of fusing for those that need it!!! Warmly, Linda
    Linda Brozik~~60 yrs. old at time of Lenke's first surgery. 62 now!
    Surgery 2006 L3/4 L4/5 double fusion/ instumentation/ With 2 cages
    This started adult onset scoliosis
    July 1st, 2010/ surgery ~~fused T10 to pelvis (long rods/ screws)
    Oct.20th 2010, extended rods to T4 / did osteotomy at L3
    Oct. 29th 2012 Dr. Lenke St. Louis Mo. T4 to sacrum osteotomy anterior cage L3/4 titanium rods
    May 30th 2013 revision
    May 8th cervicle surgery 2016
    May 31st Dr. Gupta revision 2017

  10. #25
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    Surgery was on Oct. 4

    I had my surgery on Oct. 4. They cut through the anterior. I have almost gotten over the ultra sensitivity of that. What I'm not doing so well with is PAIN in the L5/S1 area and all across, left to right, in that area, my hip joints, nerve pain, in a major way, in my right leg, like it has done since over 15 years, in increments, in different groups, in spells, but sometimes dormant (no pain at all), yada yada. But during this after surgery, the nerve pain has been pulling out all the stops and has been relentless. It is finally calming down. What I've been taking for the nerve pain is Topiramate 50 mg., up to 3 a day. For the other pain is 20 mg. Oxycodone 4 times a day & 10 Hydro/Apap 325 4 times a day. When I got home from the hosp. on Oct 6. I wasn't having pain like this at all. Most of what I was having was from the abdomen. By Sunday I was out of my mind with the nerve and post op pain. I can't describe it. I've had 3 laminectomies 2002, 03, 05, one included a fusion of L4/5 2005, a revision surgery 2007, plus the original HR surgery 1972, and as painful as those were, they don't touch this one.

    Though the pain is slowly improving I still can't help but wonder if something isn't going right.
    When I sleep, I will wake up in bad pain and have realized that it is from having wiggled around (assuming) I've been trying to get in a comfortable position and when the pain has gotten bad enough from doing that I'll wake up. So then I'll take my pain med regime and lay as still as I can until I hopefully doze off again.

    My next appt. w/the hosp. is Tues of this week. This past Thurs. I called expressing my concerns to see if I needed to be seen sooner or what ... and as we (someone there and I) were going over things, she iterated that no matter what, the pain meds would not be increased ... ... they might add a steroid but the pain meds would not be increased". It seems that the dea's changes in prescribing practices really have impacted my quality of life very negatively in many forms is my point here, I guess.

    My heart sank. Not because my pain meds would not be increased, but because she put it out there as the first point of concern or topic that may have impact on my coming in to be seen or not (2 hrs away). I made the appointment but this just stuck with me. It was the last thing on my mind - about that (shows how naive I am). As the next day rolled around, by the time I got my shower I just couldn't take another step, so I did cancel, but I did already have an appt. scheduled for this coming Tuesday - which I will make.

    My question remains, though, is: is the standard fusion/or-re-fusion and repair of a broken rod ultra ultra painful?

    Many thanks,
    Hurting in Boone,
    LindaG

  11. #26
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    Quote Originally Posted by Spine View Post
    I had my surgery on Oct. 4. They cut through the anterior. I have almost gotten over the ultra sensitivity of that. What I'm not doing so well with is PAIN in the L5/S1 area and all across, left to right, in that area, my hip joints, nerve pain, in a major way, in my right leg, like it has done since over 15 years, in increments, in different groups, in spells, but sometimes dormant (no pain at all), yada yada. But during this after surgery, the nerve pain has been pulling out all the stops and has been relentless. It is finally calming down. What I've been taking for the nerve pain is Topiramate 50 mg., up to 3 a day. For the other pain is 20 mg. Oxycodone 4 times a day & 10 Hydro/Apap 325 4 times a day. When I got home from the hosp. on Oct 6. I wasn't having pain like this at all. Most of what I was having was from the abdomen. By Sunday I was out of my mind with the nerve and post op pain. I can't describe it. I've had 3 laminectomies 2002, 03, 05, one included a fusion of L4/5 2005, a revision surgery 2007, plus the original HR surgery 1972, and as painful as those were, they don't touch this one.

    Though the pain is slowly improving I still can't help but wonder if something isn't going right.
    When I sleep, I will wake up in bad pain and have realized that it is from having wiggled around (assuming) I've been trying to get in a comfortable position and when the pain has gotten bad enough from doing that I'll wake up. So then I'll take my pain med regime and lay as still as I can until I hopefully doze off again.

    My next appt. w/the hosp. is Tues of this week. This past Thurs. I called expressing my concerns to see if I needed to be seen sooner or what ... and as we (someone there and I) were going over things, she iterated that no matter what, the pain meds would not be increased ... ... they might add a steroid but the pain meds would not be increased". It seems that the dea's changes in prescribing practices really have impacted my quality of life very negatively in many forms is my point here, I guess.

    My heart sank. Not because my pain meds would not be increased, but because she put it out there as the first point of concern or topic that may have impact on my coming in to be seen or not (2 hrs away). I made the appointment but this just stuck with me. It was the last thing on my mind - about that (shows how naive I am). As the next day rolled around, by the time I got my shower I just couldn't take another step, so I did cancel, but I did already have an appt. scheduled for this coming Tuesday - which I will make.

    My question remains, though, is: is the standard fusion/or-re-fusion and repair of a broken rod ultra ultra painful?

    Many thanks,
    Hurting in Boone,
    LindaG
    Hi Linda...

    A couple of things stand out in your post. First, it seems like your nerve pain is most bothersome. Narcotics are pretty ineffective in terms of nerve pain, so an increase might not be as helpful as you might imagine. I think the Topiramate dose can be increased over time, so that might offer hope. Secondly, if the pain is so bad that you're staying in bed all day, they need to do something to get you up and walking. It's possible that they need to change up your narcotics, to find a more effective mix. If your surgeon's office is not willing to do something about it, I'd ask for a referral to a pain management doctor.

    I don't know if it helps, but your pain will almost certainly get better, and it shouldn't be so intolerable too much longer. As to whether something might be wrong with your surgery outcome, there's always that possibility, but it's pretty unusual. If you have a fever, that could indicate an infection, which can be quite painful. Other than that, it's usually just the insult from the surgery.

    Hope you get things under control really soon.

    --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.

  12. #27
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    Pain DID Subside!

    Many thanks, Linda, for your reply! I was at an all time high in terms of pain, at least that I can remember. I should have come back here to post an update by now, as the pain did subside and settled into what I'll call a normal range for this type of surgery. The nerve pain was so elevated, to a level I don't think I've ever experienced, and I couldn't understand why. Well, any of that pain at those levels, at that point in time after the surgery, but it did level off, actually the next day. So, had I just held off another day before "losing it"!!! I do have a "pain doctor". It seems, though, that since the dea tightened their clamps on prescribing guidelines, he is more interested in discussing how the brain tricks us regarding the medications, etc., etc. - boiling down to his hesitation and anguish about prescribing, versus a time (prior to the change in prescribing guidelines) when he had compassion and gave me the feeling he cared about my pain and quality of life, but I digress. ANYWAY, I am better now. And, hopefully this surgery will make big difference when it is all said and done. I should be good, at least for a while!!

  13. #28
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    Quote Originally Posted by Spine View Post
    Many thanks, Linda, for your reply! I was at an all time high in terms of pain, at least that I can remember. I should have come back here to post an update by now, as the pain did subside and settled into what I'll call a normal range for this type of surgery. The nerve pain was so elevated, to a level I don't think I've ever experienced, and I couldn't understand why. Well, any of that pain at those levels, at that point in time after the surgery, but it did level off, actually the next day. So, had I just held off another day before "losing it"!!! I do have a "pain doctor". It seems, though, that since the dea tightened their clamps on prescribing guidelines, he is more interested in discussing how the brain tricks us regarding the medications, etc., etc. - boiling down to his hesitation and anguish about prescribing, versus a time (prior to the change in prescribing guidelines) when he had compassion and gave me the feeling he cared about my pain and quality of life, but I digress. ANYWAY, I am better now. And, hopefully this surgery will make big difference when it is all said and done. I should be good, at least for a while!!
    Hi Linda...

    Glad to hear your nerve pain has settled down somewhat. I had thigh pain after my spine surgery in 2011, and ended up in the E.R a few weeks after I left the hospital. In looking back on it, I realize that I was being a bit over dramatic. The problem was that I wasn't sleeping for several days, and I just didn't have the ability to tolerate the nerve pain.

    The opioid crisis is a real problem these days, so I think it's a good thing that hospitals are trying to regulate it better. I worked in the UCSF Spine Center for several years before retiring early this year. Several years ago, I looked at a large group of people who had surgery for scoliosis. Interestingly, when patients who were on daily narcotics prior to surgery, a significant percentage of them no longer needed narcotics on a daily basis 2 years later. But, when I looked at patients who didn't take daily narcotics prior to surgery, I found a very high percentage of them were taking daily narcotics 2 years later. Narcotics are good for helping patients get through recovery from painful surgery, but they provide no real long term benefit for most people. In recovering from both my first and second scoliosis surgeries, I weaned myself off of narcotics, not because I had no pain, but because they made me feel crappy. In both cases, I found that my pain level didn't change after weaning. We always hear that one doesn't get addicted if they take narcotics for real pain, but I think we know that's incorrect.

    Anyway, I hope your pain continues to improve.

    Regards,
    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.

  14. #29
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    Since I started here I guess I'll post this here. I wonder what a normal, typical, average recovery is for broken rod, pseudoarthrosis repair for L5-S1. Mine being on Oct. 4, I continue to have hellish pain that seems to go from the S.I. joints (both joints, same pain at same time, to the L5-S1 operative area. Things like walking to the bathroom and getting situated in bed (turning over or just moving) hurt really really bad. If I lay flat in the bed and don't move, that's when I am in zero pain, and only then. I went this Friday for my post-op visit and saw Dr. Power's FNP and mainly complained about the S. I joint pain as that had been the flavor of the day for about a week & a half but did mention the pain in the operative area (L5-S1). He took x-rays & said they'd call me in a few days. It is SO painful to walk. I've read some of the other topics about broken rod surgeries but by the time I get to the parts of recovery I've worn myself out!!! So, I'm just wondering if it is a long and very painful road? I do have a history of S. I. joint pain and am going to make a call tomorrow about getting S. I. joint injections, though the last ones were only about 6 weeks ago. I must not be living right!!!

    When I had my revision surgery in 2007, I remember that surgeon saying that the disc between L5-S1 was in good shape but if left in tact it would be only a matter of time that it would need fusing if left alone at the time of the revision, so in that 2007 revision surgery the disc was removed and fusion was attempted which I found out a couple of months ago that it didn't fuse. I just wonder what might have transpired had it been left alone. I know, too late now!

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