This Neurology & Neurosurgery forum is for questions and information regarding Rheumatoid Arthritis Neurology & Neurosurgery conditions and symptoms. All questions will receive a personal answer from a medical expert.
Yes, hardware removal including cage removal is possible. If the cage and screws are of the same material that you are allergic to then yes, all will be removed. However, if screws and plates are being removed then cage may also need to be removed if is not a stand alone device and has been held in position by the screws.
However, whether cage can be removed or not depends on many factors. Anterior cage removal is easier and less dangerous than posterior cage removal as there is less risk of injuring the cord. Also, the earlier the removal is done post surgery, the easier will be the removal due to fewer adhesions. The type of cage, its length, position or mal-position if any, condition of the vertebra, level of adhesion, strength of vertebra etc are also considered before removal. Also, the risk of removal will be weighed against risk of allergy.
If the allergy is not severe and can be managed with medications then in all probability no removal will be done. In general, posterior approach for cage removal is risky compared to anterior cage removal. If it cannot be achieved then your doctor may remove the anterior hardware and leave the posterior one. However, you need to be assessed by your specialist before any decision can be taken.
I sincerely hope you will find this information useful in your discussions with your specialist. Good Luck and take care!
It is not clear if my cages contain nickel, as I am having difficulties finding the manufacturer. My medical records only list the distributor, and they have not provided any information. I have been able to find out the screw and rods manufacturer and content, but that manufacturer said they are not their cages, due to sizes and codes.Nickel is a binder in some implants, but not all.
My next question, I hope you do not mind, is cage removal from the back standard during a hardware removal? I have seen doctors and they told me most of the hardware will be removed but not all. I did not ask them about the cages, but now I am concerned they may be left in if it is not standard procedure to remove the cages through the back. I was told removing anything from the front is too dangerous due to I have previously had front and back fusion and general they will not go in from the front again. It is unknown if the metal I am allergic to is in the cages.
My question is cage removal going in from the back standard in lumbar spinal hardware removal, when patient also has rods and screws?
If you had a patient with nickel allergy and it was unknown what her cages contained, would you also take out the cage, if you could only go in through the back?
This site complies with the HONcode standard for trustworthy health information.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.