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Plate Removal after C5-7 ACDF with plating
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Plate Removal after C5-7 ACDF with plating

Has anyone been able to get their plate removed after ACDF with plating? This plate has been a constant source of clicking and painful, difficult swallowing and choking.

One study indicated that the area where the plate is inserted is between the spine and the esophagus. The plate is 2.4 mm and the distance between the spine and esophagus ranges from 1.02 to 1.31 mm.
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Avatar_n_tn
Hi...just had plate removed from C5-7 fusion done 4 yrs ago, but it was done in order to get to C4/5 for another fusion just done last month. My neurosurgeon said he was surprised the hardware was still there since the fusion is normally complete by 3 months post op. Anyway, my surgery this last time was 90 min and that included removal of old hardware! He contacted a rep from the manufacturer who made sure he had all the right instruments for removal. I would say, too, that if it's bothering you, you should be able to have it done. I would keep searching until you find a surgeon who can help you. Good Luck!
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Avatar_m_tn
Fortunately, I haven’t had any trouble with my plate. I don’t think plate removal is that common unless their doing a revision, it’s loose or like you, someone's having serious complications? I don’t see any reason why you can’t have it removed, it’s only for stability until you fuse.

Complications from these plates, is one of the many selling points for ADR’s, and I read a few years ago about resorbable cervical plates that are made out of some type of polymer. The problem with these things is that they can only be used on single levels in the U.S. Unless the FDA has finally approved multi-level ADR’s, I don’t know if they have or not. I wish you the best of luck in finding a Surgeon to remove your plate.

Take Care
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Avatar_m_tn
Hi Kalvin,
        Thanks for responding. As you are no doubt aware, being alone to handle these matters can be very difficult. I'm very happy to hear that you are doing well post surgery. How long ago was your surgery?
        Do you feel the plate, have difficulty swallowing, pain (especially when sneezing or coughing), constant choking sensation, etc.?
        My surgeon said he has never removed one, although I suspect he meant that he hasn't removed one that wasn't "defective" per the manufacturers definition. He is a gentleman and tries his best to listen, but it is hard from a doctors point of view to understand what the patient is experiencing. One feedback from an RN indicated that removal would take less than an hour. She noted that they fill the screw holes with "bone paste". Others have referred to "bone cement" and the use of bone chips. There is even a medical code for the procedure so it must be done reasonably frequently. There is little information on this published in the US. India has some good detail about the removal of the plate as it appears much more common there.  Despite the decreased risk of simply removing the plate my surgeon uses the same risk list for removal.
        Thanks for the updates on the technology. It's very helpful. Best Regards.
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Avatar_m_tn
Hi Kalvin, I forgot to mention that the manufacturer of my plate also manufactures a "rescue screw" as well as two other "screw removal drivers", one used for removal of a properly affixed plate and one for a situation where the screw/bone connection was not achieved.
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Avatar_n_tn
Hi...just had plate removed from C5-7 fusion done 4 yrs ago, but it was done in order to get to C4/5 for another fusion just done last month. My neurosurgeon said he was surprised the hardware was still there since the fusion is normally complete by 3 months post op. Anyway, my surgery this last time was 90 min and that included removal of old hardware! He contacted a rep from the manufacturer who made sure he had all the right instruments for removal. I would say, too, that if it's bothering you, you should be able to have it done. I would keep searching until you find a surgeon who can help you. Good Luck!
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Avatar_m_tn
My Surgery was over 5 years ago, so it’s been awhile. The only time I remember having a lot pain from the plate was when I was in the recovery room and also later in my hospital room. I don’t think I’ve ever been in as much pain as I was then, because you have to swallow, eventually. It did get better over time.

I wish you the best of luck finding a Surgeon to take care of this for you, and I hope it gets rid of your pain. You’ve certainly done your research and I’ve read about people having their plates removed because of the same problems you’re having, so it’s not that uncommon. I have to have another fusion at C4-5 sometime this year and I’m really not looking forward to it, if you know what I mean.

Take Care
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Avatar_m_tn
Hi Leigh,

My surgeon will remove it. He said he had never removed one before but what he meant was that the removals he had done were in conjunction with another area to be fused.

At his hospital they have a set of tools avaiable to handle all hardware. I do have to check this out with the manufacturers representative (Zimmer).

Going back 10 or 15 years two surgeries were always scheduled, one for the installation of the plate and the other for removal of the plate post fusion. Apparently they knew when fusion was expected. As I've mentioned before, use of the plate is contraindicated (not recommended) by the manufacturer if it is not to be removed after the support is no longer required.

When I asked my NS about the removal should he find the fusion failed upon direct visual observation, he simply and gravely said that it was "very serious". I asked what he would then do and he was silent and moved on to the next topic.

Thanks for your help.
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Avatar_m_tn
I am having problems with my  plate also. I had surgery on C5-6, 21 Oct 10. After surgery Dr. told me he could not put the plate on correctly, it was not screwed all the way in, the top two screws. I have been having neck pain, feelings that I might choke, double, triple swallowing to get my food down. I live on soup and oatmeal. After my first post-op visit I informed Dr. of my symptoms and he said he would have to take plate out, I am to return 22 Dec 10 to take more x-rays and to see if some of my thoat issues have gone away. On the x-rays taken 22 Nov 10 you can clearly see that the plate is not on the spine and touching the back of my throat; you can also see that fusion has not taken place with the bone graft.

thank you
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Avatar_m_tn
in 1998 I had a titanium plate put in c-6/7 with a cadaver bone in place of disk and in 1999 they went in and put another titanium plate and cadaver bone in the c-5/6 and they piggybacked the plates instead of taking out the one plate and replacing it with one longer plate and I have had nothing but pain and body problems ever since and Iam disabled and my life ruined because I had right neck and head pain and they said that bulging discs were the cause and 1 year after the 2 surgeries a P.A. found that a 90% blocked vetebral artery was the initial cause and I didnt need any neck surgeries and here iam wondering how a nuerosugeon can miss this and they say the pain and all that goes with it is all in my head and does any other people have piggybacked plates and what are your symptoms cause they tell me after 16 years of plates and screws and cadaver bones that all the pain all these years is in my head and I feel that I cant go on anymore
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