Tlif L4/L5 fusion , found out that L4 screw is poking right thru verterbrae?is this normal?

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Im a young 49 year old man. .. ivehad a tlif to L4 /L5 about a year ago after a work accident which happened 8 months prior to my surgery. Before the surgery I had what I describe as severe toothache like pain from my right bum cheek to my foot constantly - deep nasty pain that I could barely manage. Along with the pain came a deep and dark depression that with good family love I did manage to not slip totally out of my own depth and kept on pushing forward and constantly demanding that the doctors took my situation seriously, after 9 months of steroid shots, physio, specialists who were making me doubt in myself that this situation of pain and discomfort even existed even after the MRI showed that I did in fact have a bulging disc and a far lateral annular tear to my L4 /L5 disc that I finally got to be seen by a neurologist, the neurologist did nerve conductivity tests and then a test with this very long needle and in 3 mins told me I have a far lateral disc protrusion and annular tear at L4 / L5 with an L4 / L5 right sided radiculopathy ... so I got a TLIF . Disc removed, cage, screws and rods. The day after the operation that nasty toothache pain from my bum to my foot was gone - WOW GONE! for that I'm really happy about. But a year post operation I'm still suffering a lot of nasty pain in and around my hardware area and down into my tail bone. A scan showed the L4 screw has gone right thru the vertebrae and is poking out the front by 10 mm .. is this normal ?? Does anyone else know of the issues associated with pedicle screws penertrating through vertebrae an if so does it also cause you crippling pain,????? I asked my surgeon why the screw was longer than the other 3 screws and was this what is causing me my new pain? ??, he got very abrupt and stern and pointed his finger at me and said " get your head out of thinking about that " !!!!!I felt like he didn't like me telling him I found out about this protruding screw through my own doctor(-I wonder if he was ever going to tell me that the screw was longer than the other 3?)

So can any one help me with advice or similar situations and how you found answers and or relief from this horrid back pain. Thanks

0 likes, 10 replies

10 Replies

  • Posted

    Fusionconfusion,

    Omg!! That's a nightmare, I feel for you as you are describing the screw being longer, wow, wow! He should of told you and you should be going through that pain, I have pain but it's due to a fail fusion, which my first dr screwed up, but he did do something wrong, I would definitely get a 2nd opinion.

    Good luck and hope you find relief for sure!!

    And pain free

    Cynthia( Cindy)

    • Posted

      Thanks for the reply, I will seek a 2nd opinion as its all I can do . I hope you also get some quality of life back as there isn't much quality in dealing with pain on a 24/7 basis.

    • Posted

      Fusionconfusion,

      Thank you, it's tough being with pain everyday, you feel alone but when you find people on here it gives you hope and strength from positive feedback and making friends all over, I'm one out of a thousand fusions that failed but it wasn't my dr he was a top neurologist in Connecticut, USA and it was where my cards fell, I died thru my fusion, and the dr was shocked at me even coming back and telling my story, I had a discetomy from a workers compensation dr who didn't care that my back buttocks leg and foot was on fire like a blow torch was heating it up everyday, finally after complaining to my lawyer he got me a 2nd 3rd and finally my dr who preformed my surgery a year and a day from the first surgery which was a total shock, I went to physical therapy girl was eating an apple and watching soaps and she put me in front of the jet in the pool and it erupted my disc on to my nerves, that's when I lost my bladder control and other sensations if you know what I mean, I called the Drs office after a very painful walk to my car didn't Even get out of my bath suit crawled up to my apartment on the 2nd floor, in so much pain, and had emergency surgery that day, it's a shame that the physical therapy place lied said I wasn't there threw my file away and fired the girl, so I couldn't do nothing, UGH so after complaining to him about how much burning sensation told me I was crazy and nuts in front of my boyfriend at the time and family members, pushed me back to work and work had the nerve to o put on my feet I made no lie 30 minutes they tried very hard to get me fired but had all the documentation so tgey just had to shut up and just leave me alone, so before all that I had so many different types of procedures and testing nothing worked, so I had discetomy fusion died staph infections, so now I have to be tested for mrsa if I go for any procedures, a.d on top of it all I had to have a neck fusion after falling down a flight a stairs in my apartment building 4 years ago, more pain from the fall so they decided to try the stimulator, the dr said failed SCS with the Nevro but they keep killing me with settings and they turned it on for sensation which isn't made for that model, oh sorry battery was not placed right in my back as it was very new here so after 9 painful months of the battery pushing out of my back they did the revision surgery and the battery is in my abdomen, so I'm a hot mess, but when they did the sensation on Nevro it made muscles that I didn't have pain in I have now pain in. So I'm pretty much screwed, my dr just wanted to do the revision and than turn off unit and down the road try St Jude's stimulator on me, I've been complaining but they just won't listen and I need to talk to my dr, it took 6 months just to get approved for a ct scan because the aprn went asked the dr for it he said yes but he didn't put it in, so after numerous phone calls I will find out on August 12th what's going on in my back, I know I have sclerosis which is getting pretty bad, so I don't know what the Drs have plans for that!! Ugh so sorry but just wanted to give you the last 19 years of my life in pain, got hurt at 25, 26 first surgery so next year will be my 20th year and I'm not giving up yet, i tell everyone put a smile on even though you want to cry to push that pain down, oh and for the first SCS surgery I was in bed in so much pain for 3 months til I turned it off, ugh so that's me in a nutshell, I wish everyone on here the best of luck and pain free days, stay positive and smile don't let PAIN BET US DOWN!!

      Good luck keep us updated you can always inbox me!!

      Take care

      Cynthia (Cindy)

  • Posted

    I have had two fusions of L4 L5 L5 S1 with screws, plates and a cage. The first surgery removed the disc at L4 L5 and went through the back to insert two 4 inch screws and the plate on one side of the vertebrae for stabilization. I found out my second surgery 10 yrs later that the screws from my first surgery will lose and therefore they remove them. I have a picture where it looks like two eyeballs in the vertebrae, so yes it can be normal. However, normal doesn't include pain from the instrument or hardware from the surgery.

    • Posted

      Wow, I am assuming the screws are titanium, right? The radiologist was able to see through the artifact? I have had many MRI after the surgery and there is so much distortion that we can't see anything in that area. It's blacked-out due to the magnetic field and the sound waves of the highfield MRI it is not truly the best diagnostic tests for us with hardwareach. I had a 3D reconstruction CT scan to get more accurate findings which is amazing but hard to find out in the state. However, what did the radiologist notate in the impression of the report that you should have as a patient.

    • Posted

      Sorry Alicia I had a CT scan not a MRI as I stated. The radiography report notes that the L4 screw is penetrating through the anterior vertebral body cortex

    • Posted

      Good grief! It sounds like your surgeon messed up. I was having spinal laser surgeries and needed my L4/5 disc replaced , but the surgeon couldn't get the cadaver bone he was using situated successfully to replace the list disc in the 5 surgeries he tried. I firmly believe he gave up at the last attempt, removed it, making a total of my 8 laser surgeries, and gave me the finger in the face threat when I was crying in front of others from the pain in the Recovery Room. Made me stand up, walk forwards and backwards in agony and told me there was nothing giving me pain. That my brain had become accustomed to it and I needed to get that message out of my head. An MRI and fusion two months later with a different surgeon confirmed that there was nothing where the cadaver bone should have been, and I had the nerve sandwiched between L4/5 bones The nerve was also wrapped in the scar tissue from the previous laser surgeries, so it was messed up during the fusion attempt, leaving me with some neuropathy. My friend had a situation where she had a screw poking her after she lost considerable amount of weight. The area had healed and bone had grown back so the dr just recently removed the screw as it was no longer needed. I'll have to check with her to see how she's doing. You deserve an explanation for why that screw is longer, and why it's poking through. I'm no dr., but that sounds like a screw up to me. I don't know if you'll get another dr to admit it because they don't want to get ragged into a malpractice lawsuit, but if someone can remediate the situation I'd like to know asap. Best of luck.

    • Posted

      Hi and thanks for the reply- it sure sounds like you have had a tough journey. I do hope you can get some amount of quality back in your life and progress further along the road of life with less pain and more comfort. I would really appreciate to hear just how your friends situation is with a penetrating screw and what if anything was the outcome of her problem, maybe my penetrating screw isn't causing my pain but I'm hoping that my surgeon will give me answers to what is happening inside me and if he is able to help make things better. Take care and again I hope things get better for you

  • Posted

    How are they able to see the screw being that's usually an MRI or any other test there's an artifact distorting the images? I'm 37 years old 5 8 125 pounds and my Neurosurgeon used 4 inch screws for my first surgery in 2000, if that helps you answer your question. Q.

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