Advise-Removal of hardware for L5 S1 surgery after 10 years

///Advise-Removal of hardware for L5 S1 surgery after 10 years
Advise-Removal of hardware for L5 S1 surgery after 10 years
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  • AvatarSweta
    Participant
    Post count: 1

    Dear Dr Donald,

    I am Sweta from India.

    I am struggling hard because of my health challenges and desperately looking for inputs which can give a positive direction to my treatment plan.

    I am 38 years old now and at the age of 27, I underwent a Spinal Fusion surgery of L5 and S1 (with a rod and screws) as I suffered from Spondylolisthesis Grade I with Disc Prolapse. Post-surgery new problems kept on bothering me like left SI pain, knee pain, TMJ issues .My left SI pain was so bad that that I had to leave my job for a year.

    My current complaints are – very strong pull/rotation in the lumbar and thoracic region which makes me feel imbalanced all the time. My spine also shows some scoliotic changes.My walking,sitting,lying down everything is affected and I am not at ease because of strong imbalances which many a times result into pain in left SI ,Neck,TMJ and other areas.
    Since last 4 months I am into a very bad left SI pain which inhibits be from walking,sitting,standing.

    I can share a link which has all my reports.
    My questions:
    1. Can the placement of hardware be responsible for the scoliotic symptoms and pain I experience? I never experienced scoliotic symptoms before surgery.
    2. Can the removal of hardware help me ?
    3. What is at risk if I go for removal?
    4. What options do I have to improve my condition?
    5. Do you think not addressing this will worsen my symptoms with time?

    AvatarDonald Corenman, MD, DC
    Moderator
    Post count: 6985

    You underwent an L5-S1 fusion for an isthmic spondylolisthesis 11 years ago and now have various pains but the main issue islet sacroiliac pain. My first thought is that you have a lack of fusion at L5-S1. This can be proven with a good CT scan or even some flexion/extension X-rays of your lumbar spine.

    The second possibility is that you have breakdown of a segment or two above your fusion that is referring pain to the SI joint. Your X-rays and MRI would be helpful to determine that possibility.

    Finally and much more rare is a sacroiliac joint degenerative process that caused your pain.

    It would be unlikely that only your hardware would be causing your pain but not unheard of.

    Dr. Corenman

    PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
     
    Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
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