I’ve had all my hardware removed after T2-T10 fusion. Ask me anything.

Posted by lylaaaa @lylaaaa, Nov 14, 2023

I was in a car accident and fractured several vertebrae in my thoracic spine, including a T6 burst. Fused T2-T10 in 2012.
Pain was unbearable for years and never improved.
In 2017, I got all the hardware removed. Every single piece of it. Not replaced, not revised, completely removed. It IS possible.
Realistically, your pain will not disappear. You will still have bad days and worse days.
For me, though, on a good day my pain is about 50-80% less than it was. Even my bad days and awful days (which are fewer and farther between) are nowhere near the pain I experienced before getting the hardware removed.
I searched for a couple of years for info on hardware removal but the internet is not always your best option. This was my process:
I found a new primary care doctor within a large medical system (Houston Methodist) with several hospitals and clinics in my region, so that all my medical info would be portable and easily accessed by all my doctors.
I went to see her and said simply and clearly, “I want to talk to a surgeon about hardware removal.” She did some digging and referred me to an orthopedic surgeon. I told him the same thing, answered all his questions regarding my pain, and he agreed it was a viable option.
The insurance company insisted on a procedure to make sure it would work. I was referred to a pain management doctor who gave me numbing injections at every level of my fusion. I had to rate my pain levels for a week before and a week after.
They required a 30% reduction in overall pain levels to cover the surgery.
A few weeks later, I had the surgery! I was warned in advance that they might get in there and see that some or all of the hardware was still necessary, or would be unable to be removed. Luckily, that didn’t happen. All the hardware was removed. Surgery took about an hour!

It was absolutely the single best decision I have ever made. Am I still in pain? Absolutely. Is it anywhere near the kind of pain I experienced daily before the removal? Not even close.
Hardware can removed about a year after fusion, but there is a point at which it can no longer be removed. I recommend seeing a surgeon sooner rather than later. If your doctor says no, go see another!

Photo of my removed hardware is attached (yes, I got to keep it lol).

Interested in more discussions like this? Go to the Spine Health Support Group.

anoyymous123 | @anoyymous123 | Apr 5 2:23pm

In reply to @solom174 "Yes, I am also curious about the stability of your spine without hardware - can you..." + (show)

As part pf laminectomy surgeon removed 3 spinal spacers l-3 to l-5 now her spine has shifted
very strongly suspect that this caused spondylolistheis now in greater pain and surgeon wants to do an oblique operation to "fix" problem

anoyymous123 | @anoyymous123 | Apr 5 2:31pm

In reply to @gently "anoyymyous 123 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8965756/ You might send your wife's records to UCLA for a careful opinion. I'm..." + (show)

Too late now but removing 3 spinal spacers from previous operations most likely led to spinal instability and shift of vertabrea Be very cautious if surgeon suggests this

Jennifer, Volunteer Mentor | @jenniferhunter | Apr 5 3:00pm

In reply to @anoyymous123 "Too late now but removing 3 spinal spacers from previous operations most likely led to spinal..." + (show)

@anoyymous123 I understand what you are saying. If hardware is placed externally on the spine, it does restrict spine movement. If it is removed and there has not been a spinal fusion, removing that hardware essentially allows the spine to be able to move again, and that may not be a good thing. When hardware is removed after a fusion has healed, the fused bone would maintain the support of the spine, and removal of the hardware may not make any difference as far as spinal stability is concerned. A spine with an extensive fusion or big deformity corrective surgery may need support from the hardware to remain in place. That of course is a decision between the surgeon and the patient.

I do appreciate your comments, and that is why we as patients should learn as much as we can about our condition and surgical decisions and ask lots of questions.

Jennifer

Jennifer, Volunteer Mentor | @jenniferhunter | Apr 5 3:08pm

In reply to @hannahavela906 "This is so helpful. I was in car accident on July 3, 2020 and broke my..." + (show)

@hannahavela906 Welcome to Connect! I can understand your apprehension. Is your surgery scheduled or are you still weighing the decision?

Jennifer

Phil, Alumni Mentor | @upstatephil | Apr 6 9:13am

In reply to @jenniferhunter "@upstatephil Here's what I know about removing surgical hardware. I had plates and screws removed from..." + (show)

@jenniferhunter

@upstatephil Here's what I know about removing surgical hardware. I had plates and screws removed from my ankle that were placed there in fixing a bad ankle fracture. Spinal hardware is a different animal of course. Some people (like me) react to foreign materials in their body. My orthopedic surgeon told me that about 20% of fracture patients ask for removal of the hardware because of pain. Of course healing an ankle fracture is a very painful ordeal, and for me that was much more painful than healing my cervical spine surgery, and in saying that, my spine surgery was a single level simple anterior ACDF surgery (without hardware).

It was hard to know how much pain I had from the ankle fracture injury and healing and how much was caused by my body not liking the hardware. I was getting throbbing aches and pains all the time, kind of like a kick in the shins when the hardware was in place, and it was causing some discoloration of the skin in that area. 6 months after receiving the hardware, I was getting large patches of hives that could come up anywhere, and I had to stay on antihistamines all the time or it was unbearable. My surgeon didn't think it was related, but I did, and removing the hardware resolved all of that and the throbbing pain. I do still get some aches in my ankle, and deal with tightness from scar tissue that affects ligaments and tendons because of added uneven pressure on the joint from a bit of "positional misalignment." It can cause a sudden pain when I take a step if things are not moving properly.

Having metals inside my body also worsened my asthma issues causing a lot more lung congestion and breathing issues that could easily become a chest infection. I have a lot of allergies that make my asthma worse. I know this affected me because when I broke my ankle, I had no metals in my body, and my asthma got worse after ankle fixation, and when the foreign materials were removed, my lung function improved dramatically. Doctors need a lot of degrees of proof in order to draw conclusions about relationships that are health related, so I'm not surprised that they question if there is a problem at all.

Judging after everything was healed, I can say the titanium plates and screws probably caused 60% of the pain. I've only recently figured out that the uneven tension on the joint was responsible for some dysfunction and I've been able to relieve this with physical therapy type work and myofascial release stretching of the scar tissue and lower leg muscles to loosen everything. For the first time since the injury, I have been able to walk completely pain free. My ankle was always fatiguing fairly quickly because of the added pressure of muscle imbalances and tight tissue. I still need to work on improving strength and endurance in the leg, and continue to loosen up tightness that reoccurs. Surgery creates scar tissue that gets tight, and that restriction contributes to pain. The scar tissue can be loosened, and thus improve pain. It helps to maintain this with stretching when ever it begins to tighten up again.

Jennifer

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@jenniferhunter - Good morning Jennifer. As usual...lots of great information in your post!

You mentioned something I hadn't considered: My body may react to the foreign materials now resident in my spine. I am literally researching "hives" this morning as that has become a very common and unpleasant condition. I've not considered the titanium might be the trigger.

Since all my fusions used new disks that are perforated so the new bone grows into and integrates with the artificial disks - removal is not an option.

I will add "new hardware" to my already long list of possible hives triggers! I see a long process of elimination to discover the actual hive trigger. In the meantime, I'll focus on treatment while searching for the cause.

Thanks. You're the best! I always learn from you.

hannahavela906 | @hannahavela906 | Apr 6 10:46am

In reply to @jenniferhunter "@hannahavela906 Welcome to Connect! I can understand your apprehension. Is your surgery scheduled or are you..." + (show)

I’m still weighing my decision. I’m going to get a couple more medical opinions and see what options I have before I go under the knife again!

Jennifer, Volunteer Mentor | @jenniferhunter | Apr 6 12:22pm

In reply to @upstatephil "@jenniferhunter - Good morning Jennifer. As usual...lots of great information in your post! You mentioned something..." + (show)

@upstatephil The titanium in surgical hardware is an alloy or mixture of titanium and other metals. It is possible that any of the metals used can be a culprit in an immune response.

You might find more information at https://www.orthopedicanalysis.com/ . They test for reactions to materials in implants. When I did a blood test with them, it was not covered by insurance.

Another source of information is the Environmental Health Center Dallas. https://www.ehcd.com/

They test for and treat many environmental immune issues including implant sensitivities and the type of testing they do is how they mix an antigen mixture for allergy shots which is specific to the individual patient. This is the practice that started this field of medicine although the pioneering doctor passed a few years ago. You can also search for other practitioners in this field at https://www.aaemonline.org/

I learned all of this from my doctor who was certified in Environmental Medicine. I had allergy testing and precise mixtures for allergy shots for things I am allergic to.

There is a member on Connect who traveled to the Texas location (moved out of Dallas to a suburb) for testing and treatment. You can find the discussion here.

Joint Replacements - "Is there a hospital or Dr in US who understand metal allergies in TKR?"
https://connect.mayoclinic.org/discussion/is-there-a-hospital-or-dr-in-us-who-understand-metal-allergies-in-tkr/
Jennifer

Phil, Alumni Mentor | @upstatephil | Apr 7 9:49am

@jenniferhunter - Thanks. I will proceed and check out any sensitivity I might have to the new hardware. That said - I would consider a strategy of managing the outcome (hives or other bodily rejection function) loooong before I decide to go to the OR again. 🙂

jana133 | @jana133 | Aug 4 4:30pm

Thank you very much for sharing. I am desperately trying to help my friend who had back fusion L5,S1 plus hardware put in. She is in constant- horrible pain. Can you please recommend a good surgent who would be willing to remove her hardware?
Thank you very much
Jana

Jennifer, Volunteer Mentor | @jenniferhunter | Aug 4 5:00pm

In reply to @jana133 "Thank you very much for sharing. I am desperately trying to help my friend who had..." + (show)

@jana133 Hi Jana, and welcome to Connect. I'm sorry your friend is in pain. I usually don't hear patients talk about removing spinal hardware except during revision surgery where they put in new hardware. @lylaaaa (who started this discussion about having her hardware removed) hasn't been active on Connect since December 2023. You certainly can put this question out to surgeons and try to find out if the hardware actually is the cause of the pain.

There are labs that can test for sensitivity of surgical implant materials such as https://www.orthopedicanalysis.com/ and practices in Environmental Medicine that treat patients for immune reactions to implants. This practice was the beginning of the Environmental Medicine field long ago. https://www.ehcd.com/ You may search for other Environmental Medicine providers at https://www.aaemonline.org/

It might be worth exploring some other options. I would suggest try myofascial release therapy because all surgery creates scar tissue, and this therapy can loosen scar tissue which relieves pain. I have done a lot of MFR work and released my own surgical scar tissue and have benefited a lot and reduced pain. Here is our discussion where you can learn more.

Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
I have heard surgeons say that L5 S1 is the most difficult spinal level to fuse. Is it possible that the fusion didn't take? Has anyone done any recent imaging? I guess there is lots to question here.