What is Failed Spinal Hardware?
Failed Spinal Hardware occurs the rods or screws that are holding together fused sections of the spine fatigue and break. This specific term describes patients who have not had a successful result with back surgery or spine surgery and who continue to experience pain after surgery due to failure of the failure of an implant. Back surgery can be life changing but even with optimal conditions will only be successful about 95% of the time. Since pain cannot be seen, there can be no guarantee that surgery will eliminate the pain. Selection of the correct procedure is paramount to get the best result from back surgery.
Symptoms of failed spinal hardware are generally the same as the symptoms the patient had surgery for in the first place. Pain is the most common symptom which can be chronic, debilitating, sharp or dull. The pain may have been reduced or even eliminated after the previous surgery but then returns. Regardless of the cause, the most common symptoms may include neck or back pain and stiffness, numbness or tingling in the arms and neck and legs, weakness of the arms and legs, a burning sensation in the arms and legs, trouble with walking or hand coordination.
Implants like screws or rods can assist in holding the spinal bone together while it fuses. These metal implants can wear and fatigue over time and may break before the bone has completely healed. This is called implant failure or hardware failure or metal failure. Ideally the implants should hold while the bones of the spine fuse around them, but they may fail if the spine is not supported enough while fusing. Poorly stabilized spines are more likely to have implant failure, especially in the period directly after surgery. Larger patients who put too much stress on the repair area and patients with multiple fusion levels tend to have failed spinal fusion more often.
Diagnosis of failed spinal hardware may be present immediately after surgery or may progress over a period of months or years. Diagnosis involves a combination of the patient’s history, examination and testing which may include:
- A complete physical and neurological exam which includes evaluation of loss of sensation, weakness and decreased or absent reflexes. A neurological deficit could help locate the area of cervical spinal compression. Also a review of the procedures the patient has already had is important.
- Imaging tests may include X-rays which use radiation to look at the bony anatomy of your cervical spine and may be a first test used. Computed tomography (CT) scans use X-rays and are excellent for evaluating bony anatomy or acute bleeding of the spinal cord. Imaging may show displaced rods or broken screws which would show failed spinal hardware.
Proper diagnosis is paramount with both primary back surgery as well as for failed spinal hardware. Your care will depend on the severity and causes of your symptoms. Conservative treatments include nonsteroidal anti-inflammatory drugs (NSAIDs) to decrease pain and swelling, and steroid injections that reduce swelling. Heat or cold like an ice bag, heating pad, or hot shower can help reduce pain. Physical therapy can involve muscle strengthening exercises or training in how to control your cervical spine more safely. A cervical collar or back brace might be used to support your spinal cord while limiting movement.
An additional surgery may be indicated in where there is chronic severe pain, that is not relieved by conservative treatment. Surgery will also relieve pain much more rapidly than rest and medication. Spinal fusion involves connecting two of more of the spinal vertebrae so that they are permanently attached together using bone grafts with plastic or metal screws and rods. This permanently fuses the spine vertebrae in the attached segments. This requires general anesthesia and a short hospital stay. Spine fusion for spinal instability has excellent predictive results while spinal fusion for multi-level degenerative disc disease is less likely to patient pain reduction.
The best way to manage your failed spinal hardware is to educate yourself as much as you can regarding your condition, and to become involved in your own care and treatment with your healthcare providers. Keeping your back as healthy as possible includes having a healthy weight, good posture, proper lifting techniques, and regular exercise.
The neurosurgeons of Norelle Health are highly trained and skilled in the diagnosis, management, and treatment of failed spinal hardware. Our neurosurgeons can provide the optimal treatment. Neurosurgery is considered essential by insurances and should be covered with your plan. As out-of-network providers, we will check your benefits for you and let you know what they are so there are no surprises. We use an individualized treatment plan for your concerns to provide a personalized holistic plan of care. If you would like assistance, please feel free to contact us (link to contact page) or call our office (link to phone number).