What is painful hardware?

Patients who have had a prior spinal fusion might have painful hardware as a source of their pain. This hardware might include the screw heads or rods from a fusion and the patient may be labeled with a diagnosis of Post-Laminectomy Syndrome (Failed Back Surgery Syndrome). These patients have usually had a variety of other more conservative measures they tried first without achieving substantial relief of their pain. A Painful Hardware Injection is usually a procedure that we reserve as a treatment of last resort if all other interventions such as Epidural Steroid Injections, Facet Injections, Radiofrequency Ablation and others have already been tried.

How is the procedure performed?

The hardware targets are identified under fluoroscopic guidance (X-ray imaging). First, the overlying skin is numbed with a local anesthetic. Next, a small gauge needle is advanced under that X-ray guidance until the screw head is contacted. Then, there is small amount of local anesthetic injected and the patient is brought to the recovery area. The patient will go home and we will examine the extent of pain relief within the next day or two.

What happens if I have a good response to the hardware injection?

Receiving a significant pain reduction for the time that the local anesthetic (numbing medicine) last would be considered a good response to the injection.  You should be better able to do the normally painful activities that the pain was causing.  Your pain will come back after the local anesthetic wears off.

We will follow up in the clinic shortly after the injection to discuss the results. If you had a good response, then we will discuss these results with your Orthopedic Spine Surgeon or Neurosurgeon to see if a hardware removal surgery is indicated.