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I am confused. Did you have an XLIF at L3-5 and an ALIF at L5-S1 (“Status post L3-S1 fusion”)? You had no posterior instrumentation or just instrumentation at L5-S1? Did all the segments go on to non-fusion?
Generally, titanium hardware has no nickel. If you are talking of removing the anterior plates, that creates more difficulty with your scar.
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.Sorry, took a very long time to reply. The posterior pedicle screws were removed from the index L5/S1 360 fusion for the isthmic spondylolisthesis, ~18mos after the surgery. There was a solid fusion per original surgeon, and screws removed were due to bursa over them, plus one burst fracture. The axial pain was resolved with removal.
I never addressed my mess of an unfused spine with loosening hardware, severe stenosis & large herniated disc post XLIF poor outcome because all options seemed to not account for issues with Nuvasive’s Decade plate system (1 screw per level) made from chromium cobalt, with nickel inclusion. Only option offered was posterior decompression, add more BMP & cortical screws. And now have, of course, gotten worse with pain, limitations & de-conditioning. About 6 months ago, an atrophied 2” area above plate posteriorly = skin is irritated / looks like a dark bruise & is a progression of the allergy that was considered a non issue. Removing hardware and redoing all was not something given as an option, and was the only way I’d allow more surgery since I have already been blamed for surgical choices that were not mine. Unsure if anything or anyone can address well at this point. I was told hardware would not hold unfused disc spaces, but that removal of XLIF hardware was not advised despite concerns over allergy to the hardware. Unsure if the progression of allergy & misery (& likely shown continued progression on a new MRI) would matter, since it did not before. Are there any surgeons removing / revising XLIFs vs using for revisions? I need the surgeon who can & will address, or will be bedridden for the remainder of my life, which is not much of a life. thx -
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