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    Dear Dr. Wise,
    Iwill allways be grateful to the valuable advise which you have given to me.
    I am A D-10 Paraplegic due to an accident 9 yrs. back.I have an hartshill implantation at the back which prevents me from doing an MRI which most of the neurosurgeons want in order to access and take up my case.
    Please advise as to whether I SHOULD get it removed now after 9 years.

    I wanted to get the same removed alongwith any reconstructive surgeries which I will go for after taking your suggestion about the same.


    Satish, the decision to remove instrumentation should always be based on the individual case and not on some generic rule. It is necessary to stabilize the spinal column after injury so that it can heal properly. Once the spinal column has healed, the stabilization is no longer needed. However, the instrumentation has been incorporated into the spinal scarring process and removal of the devices depend on the type and location. The decision of removal should be based on the advantages and disadvantages of removing the device. It is not a trivial matter to remove the devices. On the other hand, the devices can break and also cause undue stresses, particularly in active people, on the spine. I am not sure that getting an MRI is a particularly compelling reason for the removal, unless there is some reason to suspect that there is a problem with the spinal cord that would be better followed up with frequenct MRI. CT scans are still pretty good for detecting spine problems and the presence of metallic devices do not interfere necessarily with CT scans which is x-ray based.