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Thread: Discomfort around pelvic hardware anyone?

  1. #1
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,162

    Discomfort around pelvic hardware anyone?

    Has anyone out there had discomfort from their pelvic hardware? I have a pretty hefty set of pelvic anchors which are rather prominent. Overall I'm doing very well but I have reproducible, localized pinching-type pain that is related to certain motions, such as leaning slightly forward to look in the mirror applying makeup and then especially straightening back up from that. Not a large motion, but it hurts every time. X-rays a few months ago showed nothing loose, but it is very difficult to not worry about possible pseudoarthrosis after all I've been through. I wonder if the tissues are irritated by sliding over the prominent hardware. Any ideas?
    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

  2. #2
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,802
    Pain over iliac screws is pretty common. We probably remove 1-2 a month on average at UCSF. Typically, patients are told to wait until they're 2 years post-op. If you're thin, the risk of pain over the area is increased.

    I think it's a good idea to talk to your surgeon about your concern of non-union, though I don't remember ever hearing of anyone who had a non-union problem from removal of iliac screw(s).

    --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
    ---------------------------------------------------------------------------------------------------------------------------------------------------
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  3. #3
    Join Date
    May 2016
    Posts
    48

    Expedium 6.35 has huge iliac posts

    Leah- I don't know what hardware system you have, but that worries me about the one I am getting. The two posts that screw into the iliac are BIG, and I don't have much padding back there. I am very afraid I'll feel them poking me as I am confined to sleeping on my back. Bottom line is so much of this stuff varies dramatically from person to person, but it is messing with our natural body mechanics in the most inavsive way imaginable. Hope you find some answers. RJM

  4. #4
    Join Date
    May 2010
    Location
    Indianapolis area
    Posts
    966
    Hi Leah,

    Evelyn here. This has been my problem since T4-S1 surgery in 2012. Dr. Lenke did a CT of that area and did not find evidence of nonfusion. He said I could have the pelvic screws removed if I chose to, but did not recommend it if I felt I could live with the pain. The reason is there is some risk of destabilization. Not sure exactly what, but I decided I could live with it.

    I have been off the forum a long time and somehow missed that you had another revision last year. I'm so sorry!!!!! How are you doing now?

    Evelyn
    age 44
    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.

  5. #5
    Join Date
    Dec 2015
    Posts
    12

    Discomfort around pelvic hardware anyone?

    Me too! I am 10.5 months post L2- sacrum fusion (previous T4-L4 Harrington Rod 38 years ago). Doing great, but often if I lean forward a little or sometimes even just walking, I get a very sharp pinch or pain in right hip/buttock area. It can make me gasp, it is that sharp! Thank goodness it is very brief. I see my surgeon next month for X-rays and CT at one year follow up. I also feel and even hear a "click" when I first start walking after sitting. It seems to be localized a bit up the spine on the right side where I have two rods. It doesn't click if I lean way over or lean as far back as I can when I walk, so I am thinking it is just hardware rubbing against each other. It doesn't hurt, it is just weird. Other than these little issues, I think I am going great. Perhaps. I will eventually need a screw taken out, but I am in no hurry! If that does become a reality down the road, would the surgeon do both sides? I assume a couple years post fusion, the screws aren't really doing anything anymore? Any insite would be welcome!

  6. #6
    Join Date
    Dec 2015
    Posts
    12
    Update on pain over hardware/screws in sacrum area. It lasted about a month, then went away. When I saw my surgeon for one year post op, no complaints. He said to let him know if it recurred and didn't go away. So, I hope yours resolved also! Worse case, if we needed some screws removed in the future, that is probably a cake walk compared to what we've been through!

  7. #7
    Join Date
    Jan 2008
    Location
    Oregon
    Posts
    1,162
    I used Lisocaine patches for a number of months, and also started walking and hiking a lot. I quit needing the Lidocaine patches a few months ago, and just use one on rare occasion now. I also only need Tylenol about once a day. I am currently at the 19 month post-op mark and doing extremely well. I lost 30 pounds over the summer and fall, and my pelvic hardware is quite prominent now, especially to touch, but I don't plan to get it removed unless it became a source of chronic pain. I get a great deep tissue massage once a month, my one indulgence, and I think it has helped every part of my back including loosening all of the tight scar.
    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

  8. #8
    Join Date
    Aug 2008
    Posts
    24
    Leah, I was on the forum about 3 years ago daily complaining about the same issue. Mine was/is so severe it causes pain down a leg. It started as a pinch when I moved. After one year of having the hardware my dr did an exploratory surgery. He found my illiac screws, especially my left side loose. There was something called Metalosis around the screw from the constant movement. It looked like infection which I had a history of in prior hardware, but tested negative. Moral of the story, see your dr after a year and have it investigated. No one on the forum can tell you.

    I had my illiacs out and my lumbar hardware removd and reinstalled, tightened and built up with more fusing material. I still have left sided pain, thoracic pain from a thoracoplasty and foot pain from walking differently from all my spine issues. I did regain better motion without those illiac screws.

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