Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.

Are X-rays Needed After Back Surgery?

Friday, 08 Mar 2013 12:31 PM

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Question: I know someone who had spinal fusion and rods placed in her back. She was told to have X-rays every six months because if screws broke, she could be paralyzed. Is this possible?

Dr. Hibberd’s answer:

Spinal Fusion with rods is major surgery. It is highly unusual to be advised to have X-rays every six months to check for broken hardware. The hardware used for spinal surgery will not bend, break, or migrate without excessive direct trauma, and even in the case of auto accidents, is an unusual and uncommon event.

Screws do not break easily, and we do not recommend routine scans to look for breakage unless we suspect incorrect hardware alignment or a patient suffers back pain from significant trauma such as in a fall from a height or a serious auto accident. Any breakage or hardware migration almost always will produce symptoms.

The hardware is more resilient than bone itself. Routine back X-rays for spinal surgery patients who are not having symptoms is bad medicine and ill advised. You will need a single X-ray to assess the hardware after surgery, and a follow-up in six months to one year. But that’s all that is usually needed to assure stability of the bone structure.

There is an exception to this — when rods and wires are placed for scoliosis correction, and periodic adjustments need to be made to hardware. But the fear that a screw could break causing paralysis sounds to me very suspect, and I would seek a second opinion.

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