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Thread: Left side T1 lucency

  1. #1
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    Left side T1 lucency

    Hey there! I have a recurrent T1 lucency and my scoliosis surgeon wants to remove the pedicle screw [and ?? maybe one of my 5 rods?] at T1. He said that with time that the vertebrae ??? gets worn by the movement if the "screw is loose". [Can't remember exactly what he said]. He mentioned that it was a "small procedure" that takes "15 minutes". He said that everything appears fused, so I do not need hardware replacement.

    Oh well.

    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

  2. #2
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    Quote Originally Posted by susancook View Post
    Hey there! I have a recurrent T1 lucency and my scoliosis surgeon wants to remove the pedicle screw [and ?? maybe one of my 5 rods?] at T1. He said that with time that the vertebrae ??? gets worn by the movement if the "screw is loose". [Can't remember exactly what he said]. He mentioned that it was a "small procedure" that takes "15 minutes". He said that everything appears fused, so I do not need hardware replacement.

    Oh well.

    Susan
    Hi Susan...

    I haven't heard this, but it could absolutely be true. (I retired in 2017, so don't get to hear the scoop from surgeons every day.) The good news is that it is typically a fairly easy procedure. Nonetheless, there is always some amount of risk involved. Sorry you're having to go through more.

    --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

  3. #3
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    Quote Originally Posted by susancook View Post
    Hey there! I have a recurrent T1 lucency and my scoliosis surgeon wants to remove the pedicle screw [and ?? maybe one of my 5 rods?] at T1. He said that with time that the vertebrae ??? gets worn by the movement if the "screw is loose". [Can't remember exactly what he said]. He mentioned that it was a "small procedure" that takes "15 minutes". He said that everything appears fused, so I do not need hardware replacement.

    Oh well.

    Susan
    How long after the original surgery is it?

  4. #4
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    Quote Originally Posted by LindaRacine View Post
    Hi Susan...

    I haven't heard this, but it could absolutely be true. (I retired in 2017, so don't get to hear the scoop from surgeons every day.) The good news is that it is typically a fairly easy procedure. Nonetheless, there is always some amount of risk involved. Sorry you're having to go through more.

    --Linda
    Hi there Linda. Which part is probably true? If it is that the screw with lucency gradually wears down the area around that the screw, it makes sense that the lucent screw causes minimal frequent movement to wear down the surrounding area. I had a spinal infection with p. Acnes so maybe that figures into it.

    I did chuckle at his "15 minute surgery" calculation. The expert spine surgeon comes into the surgery suite after intubation, draping, cleaning the back with multiple anesthetics....just in time to peer int that the Fellow has positioned at the correct spot.with the fluoscope. Screw is removed and the fellow closes.
    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

  5. #5
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    Quote Originally Posted by Tina_R View Post
    How long after the original surgery is it?
    The lucency appeared at about 6 months after the 2015 surgery. First we "watched" it for a while, then I had an Inter-Stim replacement and reverse shoulder replacement. Covid caused further delay. I have had a thoracic L sided discomfort since the 2015 surgery, so hopefully screw removal will help that.
    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

  6. #6
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    Quote Originally Posted by susancook View Post
    Hi there Linda. Which part is probably true? If it is that the screw with lucency gradually wears down the area around that the screw, it makes sense that the lucent screw causes minimal frequent movement to wear down the surrounding area. I had a spinal infection with p. Acnes so maybe that figures into it.
    I just hadn't heard that lucency was a reason to remove or replace implants, unless there was pain or loss of correction. As I said, however, it's certainly possible that it's true.

    --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

  7. #7
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    Good to hear from you Susan. If it is what the Dr thinks it should be quick. Southbound surgery you never know. They were going to reconnect my rods when I broke my neck, they Dr said about 20 minutes, it was 5 hours. So you never know. But he ended up adding another level of fusion.
    I don't know if this can lead to getting a loose screw but you never know.
    My screws up that high, we're coming through the skin.
    T10-pelvis fusion 12/08
    C5,6,7 fusion 9/10
    T2--T10 fusion 2/11
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16
    Broken neck 9/28/2018
    Emergency surgery posterior fusion C4- T3
    Repeated 11/2018 because rods pulled apart added T2 fusion
    Removal of partial right thoracic hardware 1/2020
    Removal and replacement of C4-T10 hardware with C7 and T 1
    Osteotomy

  8. #8
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    I am scheduled for May 20th in Seattle. Dr. Hart said that I need to either spend the night at Swedish Hospital or in a nearby hotel. Mark and I plan to go up to Seattle on Monday afternoon and have an appt on Tuesday with Dr. Hart. I am hoping that all goes smoothly, but I have had lots of postop problems, so unsure what will happen this time.
    After 2 of my surgeries, I had severe R hand burning in the immediate postop period. The pain is a "10". The last time I screamed that they need to call an ambulance. Dr. Chen, my pain management doctor said the it was probably a positioning problem or a vasospasm. Also, since my pO2 was so low, I was sent to the recovery room intubated. When I gained consciousness in the recovery room, I could not get anyone's attention to remove the intubation. I signed via hand signs for the deaf. No one in the RR could read sign. Very frustrating.
    Hoping that the hardware removal decreases my thoracic pain.
    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

  9. #9
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    They couldn't read signs for the deaf, was that their excuse? I thought frantic hand-waving was a universal language.

  10. #10
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    Susan, Do you use oxygen? I have not heard of Po2 mentioned here, but as an adult diver, many dive companies require Nitrox certifications to dive. Nitrox is oxygenated Air. We don't monitor Nitrogen, but have to worry about Oxygen poisoning when doing a lot of nitrox diving....

    I wonder if you have an infection at that T1 screw.....When I had my 2nd molar pulled, the periodontist used tetracycline and a few other injections to put that fire out. I suppose Dr H could make a determination when he gets in there. The tetracycline was applied and then rinsed out after 60 seconds. Its a lime green colored paste. Amoxicillan does not kill all forms of bacteria. (Or dental bacteria).

    I never had 10 level burning hand pain. Had 9 level burning on the top of my ankle years ago, that kind of forced me into scoliosis surgery....which did work...

    Pulling that screw should help things..

    Ed
    49 yr old male, now 62, the new 63...
    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

  11. #11
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    Susan I hope it helps. I have not found thoracic screw removal to help much with pain. It is also a very short surgery if only the screw is removed. Maybe you won't have any problems because of such a short surgery.
    Hopefully all goes well. Let us know
    T10-pelvis fusion 12/08
    C5,6,7 fusion 9/10
    T2--T10 fusion 2/11
    C 4-5 fusion 11/14
    Right scapulectomy 6/15
    Right pectoralis major muscle transfer to scapula
    To replace the action of Serratus Anterior muscle 3/16
    Broken neck 9/28/2018
    Emergency surgery posterior fusion C4- T3
    Repeated 11/2018 because rods pulled apart added T2 fusion
    Removal of partial right thoracic hardware 1/2020
    Removal and replacement of C4-T10 hardware with C7 and T 1
    Osteotomy

  12. #12
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    Mar 2021
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    Earth
    Posts
    20
    Five rods?! that's a lot of hardware!
    Male, 15 year old manly man of manliness diagnosed with scoliosis . I have had over 30 surgeries and have 70 degree scoliosis and a twisted spine that gave me a chest point and and a rib cage back hump. I am very open about my scoliosis and started a blog about it. If you can, please take a look. The link is https://scoliaticblog.blogspot.com/

  13. #13
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    Quote Originally Posted by titaniumed View Post
    Susan, Do you use oxygen? I have not heard of Po2 mentioned here, but as an adult diver, many dive companies require Nitrox certifications to dive. Nitrox is oxygenated Air. We don't monitor Nitrogen, but have to worry about Oxygen poisoning when doing a lot of nitrox diving....

    I wonder if you have an infection at that T1 screw.....When I had my 2nd molar pulled, the periodontist used tetracycline and a few other injections to put that fire out. I suppose Dr H could make a determination when he gets in there. The tetracycline was applied and then rinsed out after 60 seconds. Its a lime green colored paste. Amoxicillan does not kill all forms of bacteria. (Or dental bacteria).

    I never had 10 level burning hand pain. Had 9 level burning on the top of my ankle years ago, that kind of forced me into scoliosis surgery....which did work...

    Pulling that screw should help things..

    Ed
    Ed,
    I do not use oxygen.
    I was diagnosed with P.Acnes bacterial infection in 2015 and take Keflex 500 bid.
    I have had 4 episodes of 10 pain in my 74 years. The first was in natural childbirth labor right before I delivered my son Marcus. At that moment, all that I could think was "very shortly either I will deliver the baby or will die "The second was a Thunderclap headache. It lasted only minutes but I thought that my brains were herniating out my ears. I held my head with my hands over my ears and prayed. The 3rd and 4th were the episodes of burning hand pain.
    Susan
    Last edited by susancook; 05-06-2021 at 01:25 AM.
    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

  14. #14
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    Quote Originally Posted by Scoliatic View Post
    Five rods?! that's a lot of hardware!
    He figured that he was sharing the stress.
    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

  15. #15
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    Jackie, thanks for your support. I am really tired of being in pain.
    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

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