Has anyone had loose screws following lumbar spinal fusion surgery?

Posted by denman55 @denman55, Aug 14, 2024

I just had my 3-month CT Scan of my lumbar spine following my L3-4-5 spinal fusion surgery. The results indicate I have a disc bulge and herniated disc at the L2-3 level and 2 pedicle screws are loose at the L3 level. I am really horrified at the results and don't know what will happen now. Has anyone experienced this?

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@denman55 My knowledge of lumbar spine surgery is from what I've learned watching surgeon presentations at conferences that I have found online. Pedicle screws can pull out if they are not placed at the correct angle. Of course bone quality (density) is important to being able to hold screws. Is that something that your surgeon checked on before doing your surgery? The lower spine has a lot of pressure from your body weight being concentrated there.

I presume you are communicating with your surgeon, and they probably ordered the x -rays. Are you getting this information from the radiologist report? Your surgeon may have a different opinion on the imaging. Radiologists need to suggest every possibility from what they see on imaging so they don't miss something. Sometimes it looks different from different angles and you need to consider all of that together to understand it in 3 dimensions.

I would be worried too. It doesn't sound like good news. Be proactive with your questions. Ask about bone quality. It is possible your surgeon will offer a revision that also includes the herniated levels above your surgical site. I'm sorry, that is a lot to be going through.

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@denman55
I am a 55 year old female who just had lumbar surgery to decompress/fuse L3-L5 due to stenosis/DDD/neurogenic claudication on 8/2/2024. I did have hardware put in. I also had cervical ACDF surgery C5-C6 with hardware in January 2022. I have not really had any issues with my cervical spine surgery or hardware and have yet to see the symptom relief post full lumbar surgery recovery.

What were your symptoms prior to surgery? Is this your first spine surgery? How old are you and do you have any osteoporosis? I have strong bones due to eating/drinking lots of dairy and think this helps secure hardware to bone.

What are your symptoms now? You mention what your MRI shows but not what your current symptoms are. Did you do anything while recovering to bend/twist in a way that impacted spine healing? Did you lift anything heavier than 10 pounds while recovering? Did you ever fall during recovery? It does sound like your higher level lumbar spine may have carried a heavier load and the level is not fused so may be more unstable which caused the new disc bulge (if it wasn’t there before surgery).

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@jenniferhunter

@denman55 My knowledge of lumbar spine surgery is from what I've learned watching surgeon presentations at conferences that I have found online. Pedicle screws can pull out if they are not placed at the correct angle. Of course bone quality (density) is important to being able to hold screws. Is that something that your surgeon checked on before doing your surgery? The lower spine has a lot of pressure from your body weight being concentrated there.

I presume you are communicating with your surgeon, and they probably ordered the x -rays. Are you getting this information from the radiologist report? Your surgeon may have a different opinion on the imaging. Radiologists need to suggest every possibility from what they see on imaging so they don't miss something. Sometimes it looks different from different angles and you need to consider all of that together to understand it in 3 dimensions.

I would be worried too. It doesn't sound like good news. Be proactive with your questions. Ask about bone quality. It is possible your surgeon will offer a revision that also includes the herniated levels above your surgical site. I'm sorry, that is a lot to be going through.

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Thank you for your reply and concern. I met with my Neurosurgeon today to review the results of the CT scan. He reviewed the scans and feels there is no need for additional surgery at this time but is going to continue to monitor me. In the interim, he has ordered an MRI and has referred me to a Pain Management physician for SI joint injections. He has also ordered a bone growth stimulator for me. I will see him again after I have the MRI done on 8/28/24.

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I have had spinal fusion on L345 and 5 years later screws come out and caused more pain and scoliosis and had S1 plate put in and broken S3&4 all of my problems were caused by degenerative disc disease and lost 4 “ of highth about 3 years later I had a full scoliosis surgery from T2 to S1 and in my palvis I spent 14 hours in surgery , had to have 4 pints of blood and been in therapy on and off ever since , I had to learn to walk again ,bend differently . I do have a balance problem in my walking at times . So I guess all the decision I made has its pros and cons but my surgeon I would. eventually be in a wheelchair if I didn’t . I probably scared you instead of helping but I hope I’ve helped also .

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I had revision spine surgery with the same neurosurgeon who did the initial emergency surgery last year. He checked the torque on all 10 screws and replaced the two that had shown lucency on a cat scan for other purposes. Put two long screws at S2. And a new spacer. The MRI showed a bone spur compressing a nerve which explained symptoms. It was a far easier surgery to recover from. This time he referred me to an endocrinologist to treat osteoporosis. He'd like his work to continue to help me. I have never had back pain. Only nerve pain. I arrived in the ER barely able to walk. He operated as soon as he could. So for some ailments this makes sense. It seems radical but nerve pain that results in numbness is no laughing matter either. But I was stronger this time.

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The first surgery was far more difficult to recover from.

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The loosening was not the problem. Caused no symptoms. I informed my neurosurgeon. So he checked all ten. And added two more. But only because of the other problem. He had to. But the loose screws didn't bother me. Ever. But could have.

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@dredk

I had revision spine surgery with the same neurosurgeon who did the initial emergency surgery last year. He checked the torque on all 10 screws and replaced the two that had shown lucency on a cat scan for other purposes. Put two long screws at S2. And a new spacer. The MRI showed a bone spur compressing a nerve which explained symptoms. It was a far easier surgery to recover from. This time he referred me to an endocrinologist to treat osteoporosis. He'd like his work to continue to help me. I have never had back pain. Only nerve pain. I arrived in the ER barely able to walk. He operated as soon as he could. So for some ailments this makes sense. It seems radical but nerve pain that results in numbness is no laughing matter either. But I was stronger this time.

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I didn't have loose hardware post surgery, but I wanted to mention that I have Osteoporosis and was on Teriparatide 1 year prior to spinal fusion, and will be on it for 8 months post surgery, at the recommendations of my endocrinologist and spinal surgeon.

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My husband was in a rollover auto wreck and landed half out of the window with the vehicle on top of him. He fractured and burst several spots in his spine and had to have rods and pedicle screws inserted. The screws came loose overtime acting like pistons. He eventually developed severe infection which led to Sepsis, Septic Shock, osteomyelitis, MRSA. and severe tissue loss. He had developed very large (basketball size) lumps on his back and severe pain. When the Neurosurgeon opened him up he couldn't understand how he was still alive.. He removed all of the metal, and had to do a bone graft and a tissue graft. Thankfully he made it through all of it but he still suffers from pain.
Don't let them tell you everything is fine. Get it checked out. If one doctor doesn't give you a satisfactory answer, find another one. You could wind up paralyzed or dead.

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