Uncertainties

How much clinical improvement will I see?

With any operation for back pain there is always some uncertainty about how much your symptoms will improve. In general, and this applies to any of the possible operations for back pain, it is unlikely that your symptoms will settle completely. Mr Boeree will only suggest surgery if he considers that there is a good chance of real improvement in your symptoms - such that you would feel that surgery was worthwhile. However, it is realistic to expect some persisting symptoms and this may well include some degree of continuing functional restrictions. The degree of improvement that you can expect depends on many different individual and personal factors. However, although there may be a good prospect of a real improvement in your symptoms it must be recognized that there is some risk that your symptoms may not be improved as much as we would hope, or indeed that you may feel that your condition has not improved at all. There is even a small risk that your symptoms could be made worse.

Will the screws and rods wear out or break?

They certainly won't wear out but there is a small risk that they may loosen or break. Sometimes (but not always, by any means) this may indicate that the fusion has not been properly formed. Investigations to look for a failed fusion may be necessary, particularly if the condition is troublesome.

Will the screws and rods need to be removed later?

Generally no. Once the fusion has developed the screws and rods have done their job and are redundant but there is no need to remove them in the vast majority of cases.

Is there a risk of transferring stress to other levels of the spine?

Stress and movement will tend to be transferred to other parts of the spine but only in a fairly small proportion of patients will this cause any clinical problems, and often not for many years. When this occurs it is called adjacent level disease. It may require further surgery if the symptoms cannot be controlled by other means.

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