Spinal fusion: Hardware removal

Posted by zorrospouse @zorrospouse, Aug 13, 2019

I had spinal surgery on L2 to S1 six years ago and am facing removal of hardware due to failure of fusion and placement. Has anyone had similar promblem?

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@sapphireblue

Thank you for your response. This is very helpful. Tomorrow will be my 1-year anniversary of having my Lower Spinal Back Fusion Surgery L4-S1. Like you I am in more pain than before. I have been on pain meds up until last weekend and they were not helping at all. My Surgeon wants me to go see a Pain Management doctor and I refuse to go after my 1st initial visit. They wanted to do the injections on me that I tried way before having my surgery and none of them worked. Since my surgery, my Surgeon has had me on Tramadol 50mg tablets 3 times a day (that are Opioids), and I was terrified to take them and slowly over time reduced the dosage myself and I was only taking a 1/2 a pill once a day along with two other prescriptions he gave to me Gabapentin 300mg Capsules (3 time's a day) and Cyclobenzaprine 10mg tablets for muscle spasms as often as needed.
In the beginning, before surgery he informed me I will not need to have physical therapy. But after a few months I asked him again and he informed me yes if I wanted to he will have me go to physical therapy. So I did it for 8 weeks and I was not feeling better at all. After I had physical therapy, the next day I would be in a lot more pain.
I ice my back everyday. Even when I sit still my lower back is hurting. It NEVER stops.
On my last appointment with my surgeon, I begged him to take out the equipment, that it hurts and I'm in worse pain than prior to surgery. He told me he could not do that. All of my equipment is Titanium. How do we go about getting the equipment removed? HELP PLEASE HELP!!!

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@sapphireblue Welcome to Connect. I have not heard of spine surgeons willing to remove spine hardware except during revision surgery that likely places new hardware in place. If you cannot have hardware removed, there may be treatments to reduce the symptoms. There are Environmental Medicine doctors who treat metal immune responses and this field of medicine was started by a practice in Texas call the Environment Health Center Dallas. Here are 2 discussions where patents are discussing immune reaction problems with metal implants and a member who is undergoing treatment with the Environmental Health Center Dallas. Here are the links:

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/

Spine Health - "Metallosis of cervical disc replacement "
https://connect.mayoclinic.org/discussion/metallosis-of-cervical-disc-replacement/

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@jenniferhunter

@sapphireblue Welcome to Connect. I have not heard of spine surgeons willing to remove spine hardware except during revision surgery that likely places new hardware in place. If you cannot have hardware removed, there may be treatments to reduce the symptoms. There are Environmental Medicine doctors who treat metal immune responses and this field of medicine was started by a practice in Texas call the Environment Health Center Dallas. Here are 2 discussions where patents are discussing immune reaction problems with metal implants and a member who is undergoing treatment with the Environmental Health Center Dallas. Here are the links:

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/

Spine Health - "Metallosis of cervical disc replacement "
https://connect.mayoclinic.org/discussion/metallosis-of-cervical-disc-replacement/

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Hi Jennifer,
Thank you for that information. I will definitely check them out. I was told by my surgeon that I will be doing just fine and the pain I had prior to my surgery will be gone. He said Nerves do not like to be touched so it will take some time to heal. But this pain from the equipment is terrible. I just want to rip it out! When I am in the lake and just standing in the water and the water is above my waist, I have no pain at all. I told my husband, that's it, I just need to become a mermaid and live in the water. LOL He laughed.
It is so hard to move around. I'm limited. I'm 57 years old and I've never been in a bad accident or lifted anything heavy that caused me harm. The Surgeon seems to think it could be from my pregnancies (I had two children); and or just me getting older. I informed him I also have MS but I'm in remission for 3 years now. I was diagnosed back in 2011, but my first symptoms were in 2001.
I don't want to be addicted to any prescriptions and there has to be another way to be able to try to live a normal life.

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@sapphireblue

Thank you for your response. This is very helpful. Tomorrow will be my 1-year anniversary of having my Lower Spinal Back Fusion Surgery L4-S1. Like you I am in more pain than before. I have been on pain meds up until last weekend and they were not helping at all. My Surgeon wants me to go see a Pain Management doctor and I refuse to go after my 1st initial visit. They wanted to do the injections on me that I tried way before having my surgery and none of them worked. Since my surgery, my Surgeon has had me on Tramadol 50mg tablets 3 times a day (that are Opioids), and I was terrified to take them and slowly over time reduced the dosage myself and I was only taking a 1/2 a pill once a day along with two other prescriptions he gave to me Gabapentin 300mg Capsules (3 time's a day) and Cyclobenzaprine 10mg tablets for muscle spasms as often as needed.
In the beginning, before surgery he informed me I will not need to have physical therapy. But after a few months I asked him again and he informed me yes if I wanted to he will have me go to physical therapy. So I did it for 8 weeks and I was not feeling better at all. After I had physical therapy, the next day I would be in a lot more pain.
I ice my back everyday. Even when I sit still my lower back is hurting. It NEVER stops.
On my last appointment with my surgeon, I begged him to take out the equipment, that it hurts and I'm in worse pain than prior to surgery. He told me he could not do that. All of my equipment is Titanium. How do we go about getting the equipment removed? HELP PLEASE HELP!!!

Jump to this post

I hear you, sounds horrible. Unfortunately puts you in the position of having to hunt down the right answer and having to go get multiple opinions. You need to do what makes sense so if you can interview several surgeons to get opinions and find out if it is possible. Fusion is not an optimal solution, we need better more innovative procedures.

REPLY
@sapphireblue

Thank you for your response. This is very helpful. Tomorrow will be my 1-year anniversary of having my Lower Spinal Back Fusion Surgery L4-S1. Like you I am in more pain than before. I have been on pain meds up until last weekend and they were not helping at all. My Surgeon wants me to go see a Pain Management doctor and I refuse to go after my 1st initial visit. They wanted to do the injections on me that I tried way before having my surgery and none of them worked. Since my surgery, my Surgeon has had me on Tramadol 50mg tablets 3 times a day (that are Opioids), and I was terrified to take them and slowly over time reduced the dosage myself and I was only taking a 1/2 a pill once a day along with two other prescriptions he gave to me Gabapentin 300mg Capsules (3 time's a day) and Cyclobenzaprine 10mg tablets for muscle spasms as often as needed.
In the beginning, before surgery he informed me I will not need to have physical therapy. But after a few months I asked him again and he informed me yes if I wanted to he will have me go to physical therapy. So I did it for 8 weeks and I was not feeling better at all. After I had physical therapy, the next day I would be in a lot more pain.
I ice my back everyday. Even when I sit still my lower back is hurting. It NEVER stops.
On my last appointment with my surgeon, I begged him to take out the equipment, that it hurts and I'm in worse pain than prior to surgery. He told me he could not do that. All of my equipment is Titanium. How do we go about getting the equipment removed? HELP PLEASE HELP!!!

Jump to this post

I don’t think the hardware can be taken out. It’s now scarred down and would probably be dangerous

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@sapphireblue

Hi Jennifer,
Thank you for that information. I will definitely check them out. I was told by my surgeon that I will be doing just fine and the pain I had prior to my surgery will be gone. He said Nerves do not like to be touched so it will take some time to heal. But this pain from the equipment is terrible. I just want to rip it out! When I am in the lake and just standing in the water and the water is above my waist, I have no pain at all. I told my husband, that's it, I just need to become a mermaid and live in the water. LOL He laughed.
It is so hard to move around. I'm limited. I'm 57 years old and I've never been in a bad accident or lifted anything heavy that caused me harm. The Surgeon seems to think it could be from my pregnancies (I had two children); and or just me getting older. I informed him I also have MS but I'm in remission for 3 years now. I was diagnosed back in 2011, but my first symptoms were in 2001.
I don't want to be addicted to any prescriptions and there has to be another way to be able to try to live a normal life.

Jump to this post

You have my sincere sympathies for your continued pain. I had a revision surgery July24,2023, at Mayo. The surgeon removed my prior hardware from fusion on L4-5, then extended down L5-S1, in a minimally invasive fusion. He prescribed 3 months of wearing a brace, doing only walking, PT after that. I had significant pain after my first fusion, it felt better after a few weeks, then the pain worsened and never improved. I don’t know if this will be the answer, but I am improving, the pain is less now. I feel a release from something, was the hardware touching a nerve? I feel it was. But in any case, it can be removed in revision surgery, get some consultations! Wishing you the best.

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@ga29

You have my sincere sympathies for your continued pain. I had a revision surgery July24,2023, at Mayo. The surgeon removed my prior hardware from fusion on L4-5, then extended down L5-S1, in a minimally invasive fusion. He prescribed 3 months of wearing a brace, doing only walking, PT after that. I had significant pain after my first fusion, it felt better after a few weeks, then the pain worsened and never improved. I don’t know if this will be the answer, but I am improving, the pain is less now. I feel a release from something, was the hardware touching a nerve? I feel it was. But in any case, it can be removed in revision surgery, get some consultations! Wishing you the best.

Jump to this post

Hi ga29,
Thank you for your response. That does give me some hope. Like you, I feel it's touching a nerve. My surgeon keeps telling me that Nerves do not like to be touched and they take a long time to recover. I understand that, but this is ridiculous. When he was informing me about the surgery before I had it, he made it sound like my pain will be gone and I will have no more pain and he did not inform me this could happen with what I'm dealing with now. There are so many times I really wish I didn't have the surgery and delt with the pain that I previously had. It was bad but not as bad as the pains I have now. I just want to rip it out!
I will definitely look into getting some consultations. Wishing you the best as well.

REPLY
@sapphireblue

Hi ga29,
Thank you for your response. That does give me some hope. Like you, I feel it's touching a nerve. My surgeon keeps telling me that Nerves do not like to be touched and they take a long time to recover. I understand that, but this is ridiculous. When he was informing me about the surgery before I had it, he made it sound like my pain will be gone and I will have no more pain and he did not inform me this could happen with what I'm dealing with now. There are so many times I really wish I didn't have the surgery and delt with the pain that I previously had. It was bad but not as bad as the pains I have now. I just want to rip it out!
I will definitely look into getting some consultations. Wishing you the best as well.

Jump to this post

I get it, I have felt like that in the past as well! My previous surgery was January, 2021, but my surgeon made sure I was aware of the risks. He said, let's see if I can remember " you have a 50% chance of a 50% reduction in pain". And it might not work and you will be worse!

I feel this time it is better, although it's only been 2 months. I am already walking a mile and a half to 2 miles daily, but it's a slow recovery and you must keep that in mind.

REPLY

I have the same question, but insurance companies are denying a lot of things these days. It's costly and they don't want to pay for it. But you can ask your insurance to see if they will approve you, you will need a medical necessity circumstance for it documented by your treating physician. Good luck.

REPLY
@sapphireblue

Hi ga29,
Thank you for your response. That does give me some hope. Like you, I feel it's touching a nerve. My surgeon keeps telling me that Nerves do not like to be touched and they take a long time to recover. I understand that, but this is ridiculous. When he was informing me about the surgery before I had it, he made it sound like my pain will be gone and I will have no more pain and he did not inform me this could happen with what I'm dealing with now. There are so many times I really wish I didn't have the surgery and delt with the pain that I previously had. It was bad but not as bad as the pains I have now. I just want to rip it out!
I will definitely look into getting some consultations. Wishing you the best as well.

Jump to this post

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!

PS: edited to add, I asked my doctor if I could keep the hardware. Took some convincing but he agreed. I’ve attached a photo of it.

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@jenniferhunter

@sapphireblue Welcome to Connect. I have not heard of spine surgeons willing to remove spine hardware except during revision surgery that likely places new hardware in place. If you cannot have hardware removed, there may be treatments to reduce the symptoms. There are Environmental Medicine doctors who treat metal immune responses and this field of medicine was started by a practice in Texas call the Environment Health Center Dallas. Here are 2 discussions where patents are discussing immune reaction problems with metal implants and a member who is undergoing treatment with the Environmental Health Center Dallas. Here are the links:

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/

Spine Health - "Metallosis of cervical disc replacement "
https://connect.mayoclinic.org/discussion/metallosis-of-cervical-disc-replacement/

Jump to this post

@sapphireblue Recently a new member @lylaaaa has joined Connect and describes having spinal hardware removed. They have responded to you in this discussion just a few posts down, and I thought I would "at mention" you so you'll get a notification. We do that by typing the "@" sign in front a member's name.

They also started a new discussion with the information as well that you can find at

Spine Health - "I’ve had all my hardware removed after T2-T10 fusion. Ask me anything."
https://connect.mayoclinic.org/discussion/ive-had-all-my-hardware-removed-after-t2-t10-fusion-ask-me-anything/

This is what is so good about Connect when we can learn about new ideas and procedures from other patients who have experienced it.

Jennifer

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