Is Minimally Invasive Surgery Necessary to Remove Spinal Implants After a Year?

The first vertebra (lumbar vertebra) underwent surgery, and after one year, is a minimally invasive surgery required for removal?

Hello Doctor: I had traditional surgery in May this year for a car accident where they installed Stryker Mantis implants, rod, and screws in my first lumbar vertebra.
I am considering minimally invasive surgery to remove them next year.
Would this be better for me? Is there a risk of nerve damage? If I do not remove them, will it cause difficulties in the future, such as during pregnancy? I have had almost no pain since the surgery six months ago.

Bao Liú, 20~29 year old female. Ask Date: 2016/12/09

Dr. Lai Zhaokang reply Neurosurgery

Hello, you are only 25 years old.
I suspect you might have a burst fracture of the L1 vertebra.
If the physician determines through imaging that the fracture has healed, it may be considered to remove the screws.
Generally, the removal of screws does not directly affect the nerves.
However, unless there are specific circumstances, lumbar spine screws are not intentionally removed.
During pregnancy, changes in body composition, weight gain, and skeletal changes can occur.
Occasionally, patients may experience discomfort from the screws, but this is not absolute.
Should you consider removal? You can discuss this with your spine specialist, Dr.
Lai Chao-Kang, the director of the Spine Neurosurgery Department at Changhua Hospital.

Reply Date: 2016/12/09

More Info

When considering whether to undergo minimally invasive surgery (MIS) to remove spinal implants, such as rods and screws, it is essential to weigh the potential benefits against the risks involved. In your case, having undergone traditional surgery for a first lumbar vertebra injury and now contemplating the removal of Stryker Mantis implants, several factors should be taken into account.

Firstly, the necessity of removing spinal implants after a year largely depends on the individual’s healing progress and the specific circumstances surrounding the initial surgery. If imaging studies indicate that the fracture has healed adequately and there are no ongoing complications, the removal of the implants may not be strictly necessary. In many cases, spinal implants are left in place unless they cause discomfort or complications. The decision should ideally be made in consultation with your spine surgeon, who can assess your unique situation based on clinical evaluations and imaging results.

Regarding the risks associated with the removal of spinal implants, while the procedure is generally considered safe, there are inherent risks involved, including potential nerve damage. However, it is important to note that the risk of direct nerve injury during the removal of well-placed implants is relatively low. Surgeons typically take great care to avoid damaging surrounding structures, including nerves. Nonetheless, complications can arise, such as infection, bleeding, or the possibility of the implants being more challenging to remove than anticipated, especially if they have integrated with the bone.

As for your concerns about future pregnancies, it is essential to understand that while spinal implants can sometimes cause discomfort due to changes in body mechanics and weight distribution during pregnancy, many women with spinal implants have successful pregnancies without significant issues. The presence of implants does not inherently preclude a healthy pregnancy, but it may lead to increased discomfort as your body undergoes changes. If you are experiencing no pain currently, this is a positive sign, but it is advisable to discuss your plans for pregnancy with your healthcare provider to ensure that you are adequately prepared.

In summary, the decision to proceed with minimally invasive surgery to remove spinal implants should be made collaboratively with your healthcare provider, considering your current condition, the potential risks, and your future plans, including pregnancy. If you are asymptomatic and your surgeon believes that the implants are not causing any issues, it may be reasonable to leave them in place. However, if you experience discomfort or have concerns about the implants in the future, discussing these with your surgeon will help you make an informed decision.

In conclusion, while minimally invasive surgery can be beneficial in certain cases, it is not always necessary to remove spinal implants after a year, especially if you are currently pain-free. Always consult with your spine specialist to evaluate your specific situation and to discuss the best course of action for your health and future plans.

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