Pedicle Screw Breach and Symptoms

[Deb97]

I am 4 months post-op L4-5 fusion.  I had very bad left leg sciatic-type pain when taken off morphine in hospital.  Dr. did ct scan and said a screw was touching nerve and said surgery would correct it, but then said I think you will be OK.  Since then, left leg pain went away after a week, but right leg and hip pain which causes chronic limping and worsening as I do anything through the day such as walking.  Also sciatic down rt. leg when lying on right side.  Chronic back pain continues similar to pre-op but w/out severe pain in legs when bending.  Dr. doesn't want to address this hardly and said scar tissue will grow and help correct this.  I ask about removing screws and he said very remote chance of doing that and that I need the instrumentation for support.  He doesn't tell me much so I got operative report and he states in it that conjoined nerves were a problem during the surgery and he tells me that is what caused the screws to be misplaced.  Question:  If one is having symptoms from misplaced screws, shouldn't those symptoms be addressed and would removal of screws be beneficial if they are causing these problems.  Would I benefit by second opinion from another neurosurgeon or orthopeadic surgeon?  Thank you.

[CCF-Neuro-M.D.-SH]

First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.    
   The symptoms that you describe are of unclear cause at the present.  You initially had left leg pain (that resolved) the right leg became affected with pain and weakness (limping).  This is not a classic pattern for a surgical complication.  I would suggest that you have more testing and then proceed after you have a diagnosis of why you are having the pain/weakness.  I recommend that you see a neurologist, and get an EMG of you legs to see where the problem is located.  You may also need another CT scan and/or a CT myelogram to evaluate the integrity of the lumbar spine.  After your workup is done, then I would consider a second opinion if surgery is needed.
I hope this has been helpful.

[Kikko]

If it were me, I would get a second opinion regarding the placement of the screw.  During my anterior fusion, one of the screws that should have been placed in the C5 vertebrae was actually put the the good disc. So naturally - no support from it.  I have to decide wether I should have it removed. It has caused the rupture of that disc and now I have more problems. The surgeon told me there was nothing wrong, so I went for a second opinion and found out the truth.  Go for the second opinion.  It is worth it.