@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.