title: Does the removal of spinal implants reduce back pain?
abstract: BACKGROUND
  The importance of the removal of spinal implants is known in the presence of infection. However, the benefits and/or risks of the removal of spinal implant for the management of back pain are not clear.
  
  
  METHODS
  In this retrospective study, we aimed to evaluate the beneficial effects of the removal of spinal implants for back pain. Study included 25 patients with thoracolumbar instrumentation.
  
  
  RESULTS
  Seventeen (68%) of them were male. Indications for spinal instrumentation were vertebra fracture (n = 9), iatrogenic instability due to multiple segment laminectomy (n = 12), and instrumentation after recurrent disk herniations (n = 4). Mean visual analog score (VAS) before the removal was 8.08. Mean VAS was 3.36 after the removal. Spinal instruments were removed after the observance of the presence of fusion. All patients were prescribed analgesics and muscle relaxants for 3 weeks before removal. Back pain did not decrease in five (20%) patients in total. Four of them had been instrumented due to recurrent lumbar disk herniation. None of the patients reported the complete relief of pain.
  
  
  CONCLUSIONS
  In conclusion, patients should be cautioned that their back pain might not decrease after a successful removal of their instruments.
authors.affiliation: Department of Neurosurgery, School of Medicine, Bozok University, Yozgat, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Ak
authors.affiliation: Department of Neurosurgery, School of Medicine, Yuzuncu Yil University, Van, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Gulsen
authors.affiliation: Department of Neurosurgery, School of Medicine, Bozok University, Yozgat, Turkey.
authors.forename: Tugay
authors.initials: T
authors.lastname: Atalay
authors.affiliation: Department of Anesthesiology, School of Medicine, Bozok University, Yozgat, Turkey.
authors.forename: Muzaffer
authors.initials: M
authors.lastname: Gencer
keywords: Back pain; Disk herniation; Spinal instrumentation; Vertebra fracture; Visual analog scale