Concerns About Spinal Screw Loosening After Minimally Invasive Surgery

The spinal fixation screws fell out two weeks after surgery?

Hello, doctor.
I suffered a spinal fracture from lifting heavy objects, and the doctor said he would only perform minimally invasive surgery, which would cost about 210,000 NTD out of pocket.
The doctor mentioned that after the minimally invasive surgery, there would be no need to remove the bone screws.
However, two weeks post-surgery, a follow-up X-ray revealed that one of the screws had become loose.
The doctor then stated that I would need another surgery to remove the screw after a year.

I would like to know if there will be additional costs for the removal of the screw, and are there any risks associated with this procedure? Will there be any long-term effects on my body? My family is very concerned.

Linda, 20~29 year old female. Ask Date: 2023/09/05

Dr. Wang Shouji reply Orthopedics

Hello, generally speaking, it is important to be cautious with activities until complete bone healing occurs before the removal of the bone screws.
The surgery for the removal of bone screws is covered by health insurance and does not require additional out-of-pocket expenses.
Changhua Hospital cares about your health.
Sincerely, Wang Shou-ji.

Reply Date: 2023/09/05

More Info

When it comes to concerns about spinal screw loosening after minimally invasive surgery, it's important to understand both the surgical process and the potential implications of hardware loosening. Minimally invasive spine surgery (MISS) is designed to reduce tissue damage and recovery time, but like any surgical procedure, it carries risks, including the possibility of hardware complications.

In your case, the loosening of a spinal screw two weeks post-surgery is concerning. Typically, spinal screws are placed to stabilize the spine and promote healing after a fracture or other spinal injury. If a screw becomes loose, it can lead to instability in the spine, which may result in pain, further injury, or complications in the healing process. The need for a second surgery to remove the loose hardware is not uncommon, especially if the screw is causing discomfort or if it poses a risk to the surrounding structures.

Regarding the costs associated with the removal of the screw, this can vary significantly depending on your healthcare provider, the complexity of the procedure, and your insurance coverage. It is advisable to discuss this directly with your healthcare provider or the billing department at your hospital to get a clear understanding of any additional costs you may incur.

As for the risks associated with removing the screw, any surgical procedure carries inherent risks, including infection, bleeding, and complications related to anesthesia. Additionally, there is a possibility that the removal of the screw could lead to changes in spinal stability, which may require further intervention or rehabilitation. However, if the screw is indeed loose and causing issues, the benefits of removal often outweigh the risks.

In terms of long-term consequences, many patients do well after hardware removal, but some may experience residual pain or instability. It is crucial to follow up with your surgeon to monitor your recovery and address any ongoing symptoms. They may recommend physical therapy or other rehabilitation strategies to help strengthen the surrounding muscles and improve stability.

In summary, while the loosening of a spinal screw can be concerning, it is a situation that can often be managed effectively with appropriate medical intervention. Open communication with your healthcare provider is key to understanding your specific situation, the associated costs, and the potential risks involved in further surgery. Your family's concerns are valid, and ensuring that you have all the necessary information will help alleviate some of that anxiety.

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