Harrington rods from 1983 - broken and causing vertebrae slippage

[ShannoninPDX]

Hello, I'm a 39 year old female. I had a spinal cord injury from a car accident when I was 8 years old. At the age of 13, I had Harrington rods put in my spine. About 8 months ago I started hearing a popping/cracking in my back. I wasn't experiencing any pain, so I didn't go to my doctor about it. The popping and cracking has increased so much recently that I finally saw my doctor about it a few weeks ago. An xray showed fractures in the rods at T11. She referred me to an orthopedic surgeon. The surgeon wanted a CT scan before he saw me. I had the CT scan last week. The radiologist says I have fractures and vertebrae slippage and he is concerned that my spine is very unstable. Now I'm just waiting to see the surgeon.

Regarding my spinal cord injury, I am a T4/5 complete para. I have basically no feeling below T4/5, although I can sometimes feel a dull lower back pain, but it is very minimal. I use a wheelchair full-time and cannot stand at all. Also, I have severe osteoporsis.

I thought that my rods were good for life. That's what the doctors told me when I had them put in. Now with these fractures, I've been doing some research online. From what I've read, it is sounding like most people have to have revisions after many years. Do they take the old hardware out and put new in? When I had the rods put in the first time, it was about an 8 hour surgery. I was in the hospital for I think about 2 weeks after the surgery. I had to wear one of those awful braces for a year after the surgery. Now it's looking like I'm going to have to have surgery again, and I'm hoping things have changed quite a bit since then. Is a brace still needed after the surgery? What is recovery time like?

Also, should I be worried about this "vertebrae slippage". My regular doctor seems pretty worried and wants me to get in to see the surgeon asap.

And just one more question (for now!), does anyone know a good surgeon in Portland Oregon?

Thank you!

[hdugger]

Hi Shannon,

Greetings from a fellow Oregonian.

I have a 21-year old son who is still pre-surgical, so I don't have personal experience. But, yes, there are a fair number of people here who have had their rods break. The rods are just meant to hold the spine still until it fuses, though, so, as long as the original fusion is still solid you shouldn't have to redo that operation. They just take the hardware out and don't replace it.

I can't help much with the fractures and vetebral slippage. Sometimes there is damage to the disks below the fusion and they have to do revision surgery to extend the fusion, but I don't know enough to say.

For surgeons, I went to the list from the Scoliosis Research Society and set up appointments with two of the doctors there (Dr. Hart and Dr. Keenen). My son's appointments are in December, so we should have an opinion on them by then.

[LindaRacine]

Hi Shannon...

I'm really sorry to hear about your problem. Although it sometimes seems like it, it really isn't anywhere near the majority of people who need revision surgery.

Your rod broke because there was an area of non-fusion from your prior surgery. It's entirely possible that the breakage and/or slippage (spondylolisthesis) occurred a long time ago.

You may hear from Leahdragonfly, who has seem Dr Robert Hart in Portland.

Regards,
Linda

[leahdragonfly]

Hi Shannon,

Hello from Oregon! As Linda mentione, I have seen Dr Robert Hart at OHSU and I liked him very much. I will need revision surgery for spondylolisthesis (vertebral slippage), spinal stenosis, bulging discs, lumbar scoliosis, and failed fusion at L4-5 (done in 1984, no hardware). Dr Hart was recommended to me by my daughter's scoliosis specialist. I also know of at least one other person from this list who had a very complex revision done by him several years ago, and she was very happy with the outcome and with Dr Hart.

Dr Timothy Keenen was also recommended to me, but he won't see you unless your insurance pays them what they want (not kidding), so they wouldn't see me even for a consult. If they accept your insurance, though, that might be a good second opinion.

Definitely check out Dr Hart. He is a member of the Scoliosis Research Society as well.

Good luck,

[ShannoninPDX]

Thank you.

My CT Scan has been sent to Dr Keenen and now I'm just waiting for him to review it and schedule an appointment. I also have an appointment with a Dr Metzger. I know next to nothing about him. I only found him in a google search. That appointment is for next Tuesday.

I'll check out Dr Hart. Sounds like he might be the man!

[ShannoninPDX]

Appt with Dr Hart on September 10th.

[hdugger]

Hi Shannon,

I'd love to hear how the appointments with Hart and Keenen go. We saw Keenen once (just as a second opinion, because my son's regular doctor seemed awfully casual about the whole thing). We liked him, but we weren't really informed enough at the time to evaluate him.

[ShannoninPDX]

Hi Dhugger,

I had my appointment with Dr Metzger today. He said that my problem was beyond what he was comfortable dealing with and he wanted me to see the doctor he studied under at OHSU.... Dr Hart! I already have the appt with Dr Hart, which is next Tuesday.

As for Dr Keenen, I've given up on him. I've called his office so many times trying to set up an appt with him and they keep blowing me off. Even my GP tried calling to schedule me and couldn't get anywhere! So I'm just going to go with Dr Hart. It sounds like he's the best in town! I will write again after my appt with him.

[leahdragonfly]

Hi Shannon,

Good luck with your appt next week. I am sure you will like Dr Hart, and I believe he is well-qualified and capable of helping you. Please do let us know how it goes.

Take care,

[ShannoninPDX]

I saw Dr Hart this morning. I liked him very much. No word yet on if I will have to have surgery. He said perhaps we could just moniter it every 6 months. I'm going back in two weeks for an MRI and we'll discuss it more at that time.

Dr Hart knows the doctor who did my surgery back in 1983. I'm in Oregon now, but I was living in MN at the time. Dr Hart said my original surgeon is excellent (or maybe I should say 'was excellent' because he is retired now) and well-known, so that made me feel good.

I have some x-rays from today. The breaks at the bottom in the lumbar are very old and not causing problems. It's the breaks at T11 that concern me.

[ShannoninPDX]

Just out of curiosity, does anyone know why there are no wires in the high thoracic/lower cervical spine?

[hdugger]

Thanks so much for the report, Shannon. It sounds like you're in good hands.

I'll post my report when we see Dr. Hart in December.

[leahdragonfly]

Hi Shannon,

I'm glad to hear your appt went well and you liked Dr Hart. It sounds like you have a good plan set in motion.

Good luckk, please let us know how things are going.