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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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    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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    Jul 2016
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    Banner Elk, NC
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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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    Jan 2016
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    Sioux City, Iowa
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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
    Join Date
    May 2010
    Posts
    345
    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
    Join Date
    Jul 2016
    Location
    Banner Elk, NC
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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
    Join Date
    Sep 2003
    Location
    Northern California
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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.

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