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Does broken rod = revision surgery?

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  • Does broken rod = revision surgery?

    Hi everyone! I am almost 2 years post-op from a T4-sacrum fusion. The last two years have gone very well so I thought I was good. Last Saturday, while standing in our motorhome, I reached across the passenger seat to put my coffee in the cupholder and I heard a pop followed by lots of pain. X-rays showed 1 of the 3 rods in the lumbar spine fractured with no loss of alignment. The pain is worse than pre-surgery because it is more acute, rather than a generalized ache. I'm seeing Dr. Lenke on Tuesday and wondering how this type of thing is usually treated. Can anyone share your experience? Thank you so much!
    3/8/16 Dr. Lenke, NY Presbyterian The Allen Hospital
    PSSIF T4-SACRUM/ILIUM, TLIF L5-S1

  • #2
    Hi....

    Broken rods usually result in surgery, but not always. Sometimes, rods break even after fusion has completed. (I suspect this actually happens in longer than average fusion rate. That is, the patient fuses slowly, putting a lot of stress on the implants. After the patient finally fuses, the micro movements that naturally occur allow the rod(s) to finally break.)

    If your pain continues, you'll probably need another surgery. The good news is that surgery to fix a single area of non-fusion and replacement of a rod is a walk in the park in comparison to the original surgery.

    Good luck!

    --Linda
    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


    • #3
      Thanks so much, Linda! That’s very encouraging!!
      3/8/16 Dr. Lenke, NY Presbyterian The Allen Hospital
      PSSIF T4-SACRUM/ILIUM, TLIF L5-S1

      Comment


      • #4
        Hi there,

        Sorry to hear this has happened to you. Try to take it easy until you see Dr Lenke, as it is easy to have a severe pain flair after breaking a rod. It is also very common to have the other rod break within a few weeks. This happened to me on two separate occasions.

        Every surgery has it’s challenges, but I agree with Linda the broken rod surgeries, while not fun, aren’t as painful as the original surgery since everything is already straightened.

        Best of luck,

        Gayle
        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


        • #5
          Thanks for responding, Gayle! I’m taking it easy because the pain is significant and I don’t want to make it worse. Your words and Linda’s are encouraging!!
          3/8/16 Dr. Lenke, NY Presbyterian The Allen Hospital
          PSSIF T4-SACRUM/ILIUM, TLIF L5-S1

          Comment


          • #6
            It's good that you don't have to wait too long to see Dr. Lenke, especially since you're having so much pain. I am 7 years post-op, but still realize is a possibility of breaking a rod. Let us know what you find out On Tuesday.
            Karen

            Surgery-Jan. 5, 2011-Dr. Lenke
            Fusion T-4-sacrum-2 cages/5 osteotomies
            70 degree thoracolumbar corrected to 25
            Rib Hump-GONE!
            Age-60 at the time of surgery
            Now 66
            Avid Golfer & Tap Dancer
            Retired Kdgn. Teacher

            See photobucket link for:
            Video of my 1st Day of Golf Post-Op-3/02/12-Bradenton, FL
            Before and After Picture of back 1/7/11
            tap dancing picture at 10 mos. post op 11/11/11-I'm the one on the right.
            http://s1119.photobucket.com/albums/k630/pottoff2/

            Comment


            • #7
              Hi Karen! Since things have been going so smoothly for me, I've been in complete denial about rod breakage. I do feel very fortunate that I was able to get in to see Dr. Lenke so quickly. The gentleman that scheduled it told me several times how lucky I was because "he never has cancellations!!"

              Dr. Lenke gave me a short-term prescription for Tramadol for pain and advised physical therapy to strengthen my core. He said there is a 50/50 chance of another rod(s) breaking and needing revision surgery. At this point I'm hoping I am just healing slowly at that level, but will eventually fully fuse. He said in recent years surgeons have started using 3, even 4 rods. During the time when just 2 rods were used, I would have had an 80% chance of breaking the other rod and needing revision surgery.

              Negativity is never a good thing, so I'm trying to stay positive. It's not working at the moment...
              3/8/16 Dr. Lenke, NY Presbyterian The Allen Hospital
              PSSIF T4-SACRUM/ILIUM, TLIF L5-S1

              Comment


              • #8
                I just sent you a long reply and lost it all. I hope that you don't have to have revision surgery, but if you do, you are in good hands with Dr. Lenke. At least those who have had revision surgery, have given you encouragement that it's not as tough as the original surgery. Hang in there!
                Karen

                Surgery-Jan. 5, 2011-Dr. Lenke
                Fusion T-4-sacrum-2 cages/5 osteotomies
                70 degree thoracolumbar corrected to 25
                Rib Hump-GONE!
                Age-60 at the time of surgery
                Now 66
                Avid Golfer & Tap Dancer
                Retired Kdgn. Teacher

                See photobucket link for:
                Video of my 1st Day of Golf Post-Op-3/02/12-Bradenton, FL
                Before and After Picture of back 1/7/11
                tap dancing picture at 10 mos. post op 11/11/11-I'm the one on the right.
                http://s1119.photobucket.com/albums/k630/pottoff2/

                Comment


                • #9
                  I broke both of my rods and in the revision surgery, Dr. Hart gave me 5 rods. He said that it takes the stress off of each rod. They are sort of tandem.
                  Here's hoping that you don't need further surgery.
                  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


                  • #10
                    Susan, 5 rods sounds like a safer bet!!

                    Sadly, I broke a second rod yesterday. Waiting to hear what’s next.
                    3/8/16 Dr. Lenke, NY Presbyterian The Allen Hospital
                    PSSIF T4-SACRUM/ILIUM, TLIF L5-S1

                    Comment


                    • #11
                      Nancy, I am so sorry this happened.....This bone growing process is not an exact science, its one of the things we have to worry about as adults doing scoliosis surgeries.

                      There have been a few rod breakers here through the years, and they all seem to come through with flying colors.

                      Susan had the heavy duty lumbar setup done....Hard to forget those x-rays....

                      I am also an RV'r so I will be careful with the coffee. I take it you were setting the cup down on the doghouse? If so, that quite a bend.

                      Be sure to let us know what happens....

                      Ed
                      49 yr old male, now 63, the new 64...
                      Pre surgery curves T70,L70
                      ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
                      Dr Brett Menmuir St Marys Hospital Reno,Nevada

                      Bending and twisting pics after full fusion
                      http://www.scoliosis.org/forum/showt...on.&highlight=

                      My x-rays
                      http://www.scoliosis.org/forum/attac...2&d=1228779214

                      http://www.scoliosis.org/forum/attac...3&d=1228779258

                      Comment


                      • #12
                        Thanks for making me smile, Ed!! You have such a way with words.

                        I was reaching across the seat to put the coffee underneath the passenger window, by the arm rest.. I thought it odd to break then because I’ve done far worse. I guess I’ll need to be much more careful and up my nutrition. I’ve never smoked, so that’s not the problem.

                        Headed back to NYC for a CT and blood work. Surgery scheduled for Tuesday 2/27 thanks to a cancellation. Very thankful, but anxious too!
                        3/8/16 Dr. Lenke, NY Presbyterian The Allen Hospital
                        PSSIF T4-SACRUM/ILIUM, TLIF L5-S1

                        Comment


                        • #13
                          Originally posted by Mom of 4 View Post
                          Thanks for making me smile, Ed!! You have such a way with words.

                          I was reaching across the seat to put the coffee underneath the passenger window, by the arm rest.. I thought it odd to break then because I’ve done far worse. I guess I’ll need to be much more careful and up my nutrition. I’ve never smoked, so that’s not the problem.

                          Headed back to NYC for a CT and blood work. Surgery scheduled for Tuesday 2/27 thanks to a cancellation. Very thankful, but anxious too!
                          I've heard it hundreds of time... breaking a rod is like breaking a paperclip. When the paperclip is bent back and forth several times, it will eventually break without any additional stress.
                          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


                          • #14
                            Originally posted by Mom of 4 View Post
                            Susan, 5 rods sounds like a safer bet!!

                            Sadly, I broke a second rod yesterday. Waiting to hear what’s next.
                            Sorry about the second broken rod, been there broke 2 also. I would post a picture of my totally awesome 5 rod back, but do not have proficiency in posting photos.
                            I know that you will be glad when your rods are replaced and you can get back to life....pun intended.
                            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


                            • #15
                              Originally posted by Mom of 4 View Post
                              I thought it odd to break then because I’ve done far worse. I guess I’ll need to be much more careful and up my nutrition.
                              By the testimonials here, it seems that bending over and reaching "can act" as a catalyst in breaking things (in adults).....I have stopped these sorts of activities because I just don't want to take that chance now that I'm getting older. Been staying vertical with reduced forces...(Model on runway balancing book on head) I am not lifting much anymore, its just way better to get somebody else to help out.

                              Dr Hu wrote an article about nutritional requirements during our recoveries, and "we are" nutritionally taxed after our surgeries, so yes, its very important to eat correctly, small amounts and often through the day. Diet takes a lot of discipline but it was psychologically important for me to adopt a "nutritional healing attitude". I would ask myself, "What can I eat that will promote healing?" Its an attitude...Be sure to let us know how things go with your revision. I don't think you need to worry, you will do just fine.

                              Susan, I do have your x-rays. I don't save many, but I do have yours since they are so special. If you want me to post them here, I can do that if you wish. I can also send them to you if you lost them.

                              Ed
                              49 yr old male, now 63, the new 64...
                              Pre surgery curves T70,L70
                              ALIF/PSA T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
                              Dr Brett Menmuir St Marys Hospital Reno,Nevada

                              Bending and twisting pics after full fusion
                              http://www.scoliosis.org/forum/showt...on.&highlight=

                              My x-rays
                              http://www.scoliosis.org/forum/attac...2&d=1228779214

                              http://www.scoliosis.org/forum/attac...3&d=1228779258

                              Comment

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