Re: Luque rods with sublaminar wires - problems

[Guest guest]

Hi, Mountaingaze, and welcome to the Feisty group!

I am the group founder/list owner, so I have had the

opportunity to read other people's spinal sagas for

six or seven years now. I do NOT often hear about

sublaminar Luque wires, though, so my " eyes perked up "

when I saw your post.

I'm sorry to say that SOME surgeons were still using

this quaint method of spinal fixation circa 1986, a

year after your own surgery. I had a second spinal

fusion that year for adult deterioration below the

termination of my adolescent, T4-T12, uninstrumented

fusion. The procedure was probably somewhat similar to

your own " modified Harrington " -- extension of the

original fusion to L3, implantation of a Harrington

rod with Moe hooks, plus use of sublaminar wiring

(lumbar in my case).

I have not had problems identical to yours, but like

many at this group, I have certainly had my share of

paresthesias over the years -- every kind of weird

buzzing, " electroshocking " sort of sensation, various

sharp nerve-pains, intermittent numbness in a number

of different areas at different times. Before my first

flatback revision operation in 2001, I was also

frequently plagued by extremely severe sciatica. Now a

graduate of six revisions, I can not sit for long with

my torso leaning out over my legs (i.e., picture a

less forward-leaning female version of Rodin's

sculpture " The Thinker " ). When I do so, I end up with

totally numb legs bilaterally and must hold on to

nearby objects when I stand up so as not to go

crashing to the floor. My legs usually " wake up "

within 60 seconds or so after this gingerly change in

position. Lately I have also woken up in the morning

with pain of 9 (0-10 scale) in both metatarsals. I

have NO idea what is causing this last but am due to

see a podiatrist and will ask.

My Luque wires are long gone (at least if I am

remembering my latest films accurately -- I have had

much hardware in and out, including the H. rod and a

later pair of iliac bolts that were bugging me

extremely), so I can't relate much if any of this

symptomatology to those wires, or in fact to any given

component of my surgical steel and titanium

collection. And I wish I could tell you whether your

own problems are related to the wires per se, but I

fear no one you talk to online can give you a

definitive answer.

I hope that you can get to an exerperienced adult

spinal deformity surgeon (NOT your basic SRS

scoliosis-correction surgeon, even if his or her

practice includes many adults -- that is, NOT anyone

analogous to the surgeon who put in your rod and wires

back in 1985; you need a new and considerably more

subspecialized level of diagnostic expertise at this

point). Your shoulder " catch " sounds particularly

awful. You can not be enjoying a comfortable life with

all this stuff going on. You need a thorough neuro

assessment.

To stick my neck out just a little, though: I am not

sure you need to be overly concerned about the Luque

wires specifically -- that is, don't worry or panic

because these wires have been implicated in certain

nerve or other problems. The SRS was already well

aware of the risks in 1985 -- one of my former

colleagues at JAMA (where I was a medical news writer

during that general era) had recently written an

exhaustive feature story covering these and other

concerns, so I was pretty well informed when I opted

to let my surgeon put wires in my spinal canal. By the

following year, C-D rods were all the rage, and

progress marched on -- but did not leave me much the

worse for wear courtesy of Dr. Luque. My real problem,

of course, was severe progressive flatback syndrome

from the Harrington rod. That problem has now been

corrected with tremendous skill and exactitude. I am

thankful and blessed to have found two surgeons who

were up to the challenge. Of course the operative

reconstructions exacted a pretty high price from me --

physically, emotionally, existentially.

The good news, for you, is that the right specialist

should be able to tell you whether the Luque wires are

implicated in your symptoms (probably after further

testing -- ideally, noninvasive). If they are somehow

causative, then, contrary to what one MD-patient told

me years ago, a leading spine surgeon told me more

recently that removing these wires is really no big

deal.

Of course, if any further surgery is proposed to you,

you will want to find out about possible risks from

the surgery itself. I get the impression that today's

topnotch surgeons rarely if ever see a case of

paralysis. Nerve root compression is somewhat more

common but can often be reversed completely.

Apart from surgery, there are a number of medications

that people find helpful with verious types of nerve

pain. You will probably want to explore all pssible

medical approaches.

In your case, specifically, I would tend to suggest

that you see a neurosurgeon specializing in the

problems of adults with histories of previous

scoliosis surgery.

Maybe others here will have more helpful comments or

suggestions for you. In any case, I hope you will keep

us posted on your quest for answers and for relief

from your pain. Thanks for your interesting post; and

again, a warm welcome to the Feisty Forum.

Best,

--- mountaingaze1 <otismontain@...> wrote:

>

> Hello Feisty Folks-

>

> I'm new to this group....and in reading many of the

> previous posts, I

> see there are some folks out there who have had

> Luque rods with

> sublaminar wires placed ( or Harrington with

> sublaminar wires ). I am

> very interested to know if any of you are having

> nerve issues?

>

> I'm 42, and had a spinal fusion in 1984 to correct

> kyphoscolosis.... T2

> through T 12 with Luque rods and sublaminar wires.

> I've been told by

> my ortho surgeon that this procedure became obsolete

> within a year or so

> after I had it performed. My further investigation

> has revealed that

> the sublaminar wires had stopped being used because

> of nerve issues

> ...due to the wires being placed through the

> vertebra.

>

> Progressivly over the past 3 years I have developed

> some rather peculiar

> problems ... which I suspect are related to my

> spine....and I question

> if they might be caused by the wires. The two most

> bothersome are 1) a

> tremor/ throbbing / electrical sensation throughout

> my body .....which

> waxes and wanes and changes, but never goes away 2)

> a 'catch' that has

> progressivly become worse over several years. It is

> to the right of my

> spine between scapula at about T 5. It sometimes

> radiates through to

> the front at the sternum, and sometimes that rib is

> very tender. It can

> be aggraved with some simple movements, like

> shifting a standard car,

> and sometimes becomes sharp like a knife.

>

> Anybody experiencing similar problems?

>

> Mountaingaze

>

>

[Guest guest]

Hi,

I had Luque rods " installed " in 1996 (T4 to L4). As of today, I

don't have anything like the nerve issues you are describing, but

then again, you have been fused 12 years longer than I have. Your

fusion location is also a bit higher. I don't have any idea if

those items are enough to cause you to have issues where I don't.

(I don't even play a doctor on TV :-)

Nerve-wise, I do have decreased sensation in certain parts of my

legs and torso. I can't say if that's from the Luque rods/wires or

just part of having fused vertebrae.

I hope you find the right specialist for you.

>

>

> Hello Feisty Folks-

>

> I'm new to this group....and in reading many of the previous

posts, I

> see there are some folks out there who have had Luque rods with

> sublaminar wires placed ( or Harrington with sublaminar wires ).

I am

> very interested to know if any of you are having nerve issues?

>

> I'm 42, and had a spinal fusion in 1984 to correct

kyphoscolosis.... T2

> through T 12 with Luque rods and sublaminar wires. I've been

told by

> my ortho surgeon that this procedure became obsolete within a year

or so

> after I had it performed. My further investigation has revealed

that

> the sublaminar wires had stopped being used because of nerve issues

> ...due to the wires being placed through the vertebra.

>

> Progressivly over the past 3 years I have developed some rather

peculiar

> problems ... which I suspect are related to my spine....and I

question

> if they might be caused by the wires. The two most bothersome are

1) a

> tremor/ throbbing / electrical sensation throughout my

body .....which

> waxes and wanes and changes, but never goes away 2) a 'catch'

that has

> progressivly become worse over several years. It is to the right

of my

> spine between scapula at about T 5. It sometimes radiates through

to

> the front at the sternum, and sometimes that rib is very tender.

It can

> be aggraved with some simple movements, like shifting a standard

car,

> and sometimes becomes sharp like a knife.

>

> Anybody experiencing similar problems?

>

> Mountaingaze

>