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  • #31
    Originally posted by Pooka1 View Post
    Have they ruled out infection as to why you have pain in the area of instrumentation?

    http://www.ncbi.nlm.nih.gov/pubmed/24487974

    http://www.ncbi.nlm.nih.gov/pubmed/20032526
    Sharon, the article about adolescent instrumentation removal was interesting as the #1 reason for removal was "fistula" [I think the # was 38.9%]. Yikes! Exactly what do they mean?
    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


    • #32
      Originally posted by susancook View Post
      Sharon, the article about adolescent instrumentation removal was interesting as the #1 reason for removal was "fistula" [I think the # was 38.9%]. Yikes! Exactly what do they mean?
      Susan
      I don't know what they mean. Maybe Linda can tell us.
      Sharon, mother of identical twin girls with scoliosis

      No island of sanity.

      Question: What do you call alternative medicine that works?
      Answer: Medicine


      "We are all African."

      Comment


      • #33
        A fistula is an abnormal channel or opening from one structure into another due to infection.

        Doesn't sound good at all!
        Gayle, age 50
        Oct 2010 fusion T8-sacrum w/ pelvic fixation
        Feb 2012 lumbar revision for broken rods @ L2-3-4
        Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


        mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
        2010 VBS Dr Luhmann Shriners St Louis
        2017 curves stable/skeletely mature

        also mom of Torrey, 12 y/o son, 16* T, stable

        Comment


        • #34
          Originally posted by titaniumed View Post
          And thank you Sharon for posting, and I thought it was just me that thought curve progression was risky after implant removal. I guess some surgeons “don’t” reveal all the facts. (For the Facebook group)

          Patients should be cautioned that hardware removal after posterior spinal fusion may not provide complete pain relief. Furthermore, there is risk for curve progression following removal of instrumentation, particularly in the setting of infection. Back pain may be an indicator of infection, and intraoperative cultures should be taken at the time of implant removal.

          I'm not a surgeon, but I can read. I might not be a revision patient, but it is my business to be informed.

          Sorry for the rant.

          Ed
          If you're removing implants on a child or young adult, there is a risk of minor curve progression over the patient's lifetime. I think the progression is rarely enough to require treatment, but nonetheless, it's something that should be disclosed. If you're talking older adults, the risk of progression comes from the lack of solid fusion. It is irresponsible for a surgeon to not disclose that information. The risk of reoperation is there whether the implants are removed or not.
          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


          • #35
            Originally posted by leahdragonfly View Post
            A fistula is an abnormal channel or opening from one structure into another due to infection.

            Doesn't sound good at all!
            When someone has a deep infection, I think it often (maybe even always) forms a fistula. Without getting too graphic, there has to be somewhere for the biproduct of the infection gets stored.
            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


            • #36
              good luck with your surgery
              Kara
              25
              Brace 4-15-05-5-25-06
              Posterior Spinal Fusion 3-10-10
              T4-L2
              Before 50T
              After 20T

              Comment


              • #37
                I get what a fistula is....but why did 38% of the adolescents have fistulas and it is not mentioned at all for the adult population?
                What am I missing?
                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

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