### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I am 10 months post op of spinal fusion surgery. In February of this year I was facing severe pain in my back, so i visited my surgeon only to find out that the 3 bumps bulging from my back were screws rubbing against my skin. He told me he was going to wait until October to go back and do another surgery to make sure that my back is healed. For the next 4 to 5 months I was taking strong pain medication to reduce my pain. In June I stopped taking them and i was doing good for 3 months. But now that im back to school and playing volleyball the pain came back but it was worse. I have about 2 episodes of stabbing and burning pain just above the screw every hour. I was wondering if it was maybe a broken screw?

### output:

HiT hank you for your question to Chat Doctor. Causes of back pain after spinal surgery are several and may be hardware related or pathology in the back itself.Some common causes are infection, nonunion of the bones one of the strong predisposing factors for which is infection and prominent hardware. Screw heads may become prominent in thin individuals and cause problems. Infection is a major concern if there is increasing pain and MRI scan and blood tests can help with diagnosis. Diagnosis of nonunion requires a CT scan. An X-ray will reveal a broken screw in most of the cases. CT scan images the spine in three dimensions and is confirmatory. For your condition I would recommend a CT scan and MRI of the spine with and without contrast. A prominent or broken screw is uncommon to be the cause of pain by itself. It is the nonunion which is indirectly indicated by a broken screw that is the cause of pain. Hope this is helpful. I would be happy to answer any questions you may have. Wish you the best.