A newbie to the forum.......

[susancook]

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

[Pooka1]

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.

[leahdragonfly]

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

Doesn't sound good at all!

[LindaRacine]

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.

[LindaRacine]

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.

[kennedy]

good luck with your surgery

[susancook]

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