J Korean Neurosurg Soc.  2008 Mar;43(3):139-142. 10.3340/jkns.2008.43.3.139.

Efficacy of Spinal Implant Removal After Thoracolumbar Junction Fusion

Affiliations
  • 1Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Korea. chosunns@hanmail.net

Abstract


OBJECTIVE
The purpose of this study was to evaluate the efficacy of spinal implant removal and to determine the possible mechanisms of pain relief.
METHODS
Fourteen patients with an average of 42 years (from 22 to 67 years) were retrospectively evaluated. All patients had posterior spinal instrumentation and fusion, who later developed recurrent back pain or persistent back pain despite a solid fusion mass. Patients' clinical charts, operative notes, and preoperative x-rays were evaluated. Relief of pain was evaluated by the Visual Analog Scale (VAS) pain change after implant removal. Clinical outcome using VAS and modified MacNab's criteria was assessed on before implant removal, 1 month after implant removal and at the last clinical follow-up. Radiological analysis of sagittal alignment was also assessed.
RESULTS
Average follow-up period was 18 months (from 12 to 25 months). There were 4 patients who had persistent back pain at the surgical site and 10 patients who had recurrent back pain. The median time after the first fusion operation and the recurrence of pain was 6.5 months (from 3 to 13 months). All patients except one had palpation pain at operative site. The mean blood loss was less than 100ml and there were no major complications. The mean pain score before screw removal and at final follow up was 6.4 and 2.9, respectively (p<0.005). Thirteen of the 14 patients were graded as excellent and good according to modified MacNab's criteria. Overall 5.9 degrees of sagittal correction loss was observed at final follow up, but was not statistically significant.
CONCLUSION
For the patients with persistent or recurrent back pain after spinal instrumentation, removal of the spinal implant may be safe and an efficient procedure for carefully selected patients who have palpation pain and are unresponsive to conservative treatment.

Keyword

Spinal implant removal; Back pain

MeSH Terms

Back Pain
Follow-Up Studies
Humans
Palpation
Recurrence
Retrospective Studies
Full Text Links
  • JKNS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr