HARDWARE BLOCK
If you still continue to
experience pain after spine surgery, hardware block is performed to
determine whether a specific piece of hardware is causing the pain and
needs to be removed surgically.
Before the procedure, blood
thinners such as heparin, warfarin (coumadin), aspirin, and
anti-inflammatory medications (except for celebrex) must be discontinued
5 days prior to the procedure date. If you are being treated by any
specialist, medical clearance may be needed to proceed. The morning of
the procedure, you may have something to eat or drink but nothing within
2 hours of the procedure.
At the surgical center an IV
will be started by a nurse. When ready you will be taken to the surgical
suite where you will be placed on your stomach for the injection. This
sterile procedure is performed under IV sedation. The area to be
injected will be prepped and anesthetized with lidocaine (local
anesthetic). Then under fluoroscopic (real time x-ray) guidance, spinal
needle(s) will be inserted alongside the hardware. Contrast dye is
injected to confirm the medication is delivered to the correct location.
Then a local anesthetic will be injected into each site. During the
procedure your vital signs and oxygen saturation will be continuously
monitored. After the injection, you will be taken to the recovery area
and be evaluated. If your pain goes away after the injection, it is
highly likely the specific hardware that has just been injected is the
pain generator. You will be monitored until discharge criteria are met.
You will need a family member
or friend drive you home following the procedure. No exceptions. You may
also experience some temporary spasms near the injection site. If this
occurs use ice or heat, whichever works best for you. If you are using
ice, place a thin clothe barrier between your skin and the ice pack.
Apply for 20 minutes to the affected area and you may reapply in 60
minutes if needed. If you are applying heat (moist or dry heat) refer to
the manufacturer‘s instructions for application. Never sleep on a
heating pad, burns may occur.
Complications are rare and include but not limited to
bleeding, infection, damage to nerves and structures of the spine,
spinal headaches, perforation of organs, collapsed lung, reaction to
medications, increased pain, seizure, stroke, paralysis, damage to fetus
if pregnant and death. You may be given antibiotics during the
procedure. Your usual pain may be increased for a few days after the
procedure. Sedation is used for patient comfort and to facilitate
performance of the procedure. Complications of sedation are very rare
and include aspiration, pneumonia, and loss of airway requiring
emergency resuscitation or surgery. The risk of complications requiring
transfusion is extremely low. The risks of transfusion of blood products
include transfusion reaction, infection such as HIV or hepatitis and
death.
