[mmglobal]

Judy, I'm so sorry about your situation. I can only imagine the pain from such an operation. Hopefully it will be worth it in the long run. If so, you'll look back and it wont seem so bad.

I have seen revisions with loose screws. They take out the old one and put in a bigger one with better 'purchase'. The original fusion and these types of complex revision surgeries are very difficuly carpentry jobs. There is a huge difference from one carpenter to the next. Some of us will have problems that could not have been avoided by any surgeon, while others may have problems that would have been avoided by a better carpenter. It will be difficult to say which category you fall into unless there are obvious errors, cut corners, compromises, etc....

In any case, the carpentry that needs to be performed must be done on the situation that you'll present. If the stripped screw is a small screw in a large piece of bone (or wood), it's not problem to put in a bigger screw. There is plenty of structure left to support the bigger and stronger screw that has more surface area to hold onto. If there is not enough structure left, the woodworker gets to get another 'blank' and start anew. You don't have a blank to replace the violated bone.

I'd make certain that the surgeon has a great deal of complex revisions. (Hopefully, they are not because HE screws up often and must fix his mistakes!) Unless it's very clear that he could not have done a better job on the original surgery, I'd have a hard time going back to the same surgeon. You wouldn't return to an auto mechanic that had to redo much of his work.

The surgeons who have done a LOT of scoliosis work tend to be good at these surgeries. Fabien Bitan in NY, Serena Hu in SF come to mind. I'm sure that there are many other excellent surgeons around... but do you homework, and don't accepy, "Oh, I've done many." It's more like, "I was the presidend of the pediatric scoliosis society and may practice focused on scoliosis for the first two decades." (Scoliosis surgery is not the only specialty that lends itself to better experience with complex revisions, but it's a great one.)

If any redo surgery must extend the fusion, or if fusion has not occurred, perhaps it's possible incorporate an ADR into the structure to reduce the adjacent segment degeneration that may occur on top of, or below the fusion?

All the best,

Mark

PS, all the appropriate, "I'm not a doctor" qualifiers, apply here. Also... anyone could easily become psycotic after a protracted battle with such severe pain. I did, and so did I.