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Thread: metal implant toxicity?

  1. #1
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    metal implant toxicity?

    Hello,

    I had the Harrington procedure in '78. I'm now 50. Am very athletic and don't experience much low back/sciatica pain except when I run the bases in softball games (which is probably normal for a woman of my age).

    However, I do have recurrent episodes of unexplained low-grade fever, general malaise, and in 1992 developed a condition where I break out in massive hives if my skin is exposed to the slightest cool air or water. I am literally allergic to cold and the severity of the condition was brought to my attention when I almost suffocated as my body was covered in hives and my airways closed after being submerged in a cold river for 10 minutes.

    Research has revealed that metal implants corode in the body releasing heavy metals, compromising the immune system and causing vasculitis which causes hives, fever, cancer, strokes. . .well you can see where I'm going with this.

    Has anybody else heard of or had direct experience with these symptoms? Please write. Thanks.
    Cindy

  2. #2
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    Hi Cindy...

    I believe that the only time metal toxicity is shown to have caused problems is when the metal is being shed into the surrounding soft tissue. That happens when one component of the hardware is loose, and allows another element to rub against it.

    If you think your implants are causing the reaction you mention, you should discuss having them removed. Once your fusion is solid, there is not sufficient reason to leave the implants in place if they're causing difficulty.

    And, be careful about what you read on the internet. There are thousands of us with metal implants who have not had any adverse effects. :-)

    Regards,
    Linda

  3. #3
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    Thanks for your comments, Linda. I know the internet contains many opinions and in this case I was paraphrasing from studies published in Orthopaedic Medical Journals. I was left with the impression that metals in a biological environment release ions resulting in immune system hyper-activation.

    I want to make certain that metal allergy is the cause of the problem before I undergo rod removal procedure since the rods themselves are not causing pain.
    Cindy

  4. #4
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    Originally posted by Janamom
    T I was left with the impression that metals in a biological environment release ions resulting in immune system hyper-activation.
    If that's the case, wouldn't one have to assume that we'd all have problems?

    --Linda

  5. #5
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    Apparently, some are more senstive than others.
    Cindy

  6. #6
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    Hi Cindy...

    Someone who read this thread was kind enough to send me a PDF of a published paper about a man who had a stainless steel implant in his arm for 40 years. When the implant was removed, it showed no corrosion. Here's a link to download the paper:

    http://content.kluweronline.com/arti...1/fulltext.pdf

    Regards,
    Linda

  7. #7
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    Thanks for forwarding me the info. I'm no biochemist, but I'm not sure the absence of visible corrosion suggests that metal ions are not formed in the body. I'll look forward to researching this subject more thoroughly.
    Cindy

  8. #8
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    Cindy...

    I'll look forward to hearing what you find.

    I'm definitely not a scientist, and don't have the knowledge to understand much of this. If there is metal in surrounding tissue, where would it come from if the implant doesn't show corrosion when viewed on an electron microscope?

    --Linda

  9. #9
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    I don't know why corrosion is not visible. Here's the abstract.

    http://www.ncbi.nlm.nih.gov/entrez/q..._uids=21161053
    Cindy

  10. #10
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    implants

    I read that abstract just now and it mentions joint implants, some of which consist of plastics and metal and are cemented in place. This is not used in scoliosis surgery. There are ions released when the cement is inserted.
    From this article:
    "Until the roles of delayed hypersensitivity and humoral immune responses to metallic orthopaedic implants are more clearly defined, the risk to patients may be considered minimal. It is currently unclear whether metal sensitivity is a contributing factor to implant failure."

    Usually many studies are needed to suggest one conclusion or another. Some studies are flawed and biased. We are always learning.

    I notice a lot of hysteria on the internet about fillings, implants and scoliosis surgery. It is an imperfect world with no guarantees.

    I personally glad I have all my metal which gave me my life back.
    Karen

  11. #11
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    Hi Cindy and Karen...

    I wrote to the senior author of the study referenced by Cindy, and got the following reply (quoted with his approval):

    "Hello Linda

    Thanks for the paper. It was an interesting finding alright. Unfortunately, it is the exception and not the rule. Most of the time there is plenty of evidence of corrosion. While we are hard at work trying to find a link between spinal implant debris, metal hypersensitivity and LOSP or poor implant performance, the connection between them is not yet well established. It is more so with hips and knees. Thus it seems probable that a similar phenomenon can occur with spine implants. If their implants have fulfilled their duty and are easy to get at, then the risks of implant debris pathogenicity may outweigh those of re-operation. Having talked to a few patients myself there does seem to be more of a possible connection when LOSP reaches intolerable levels, or if localized/generalized eczema/inflammation seem temporally or otherwise associated with their implant.

    I believe the scientific consensus is: that implants do not in and of themselves represent a pathogenic risk over time. However, implant debris does. If the implant is not well fixed or corroding excessively then pathogenic debris may warrant removal/revision. Additionally, certain individuals may be predisposed to excessive bioreactivity (specific or non-specific) to particulate or soluble debris which are released from all implants, even the one in that article.

    So how’s that for a convoluted answer. We are currently working on ways to determine if someone is a hyper-responder to implant debris, and we currently have some basic metal allergy testing (Lymphocyte Transformation Testing, LTT) we do for patients that are particularly concerned about specific metals, but the utility of such testing is not established clinically.

    Having that test done is one way to allay or partially validate patient concerns. I have attached our protocol in case you are interested.

    Good luck and feel free to contact me for any further questions… and thanks again for the article.
    Best Regards
    Nadim

    Dr Nadim James Hallab
    Department of Orthopedic Surgery
    Rush University Medical Center"


    It sounds to me that Nadim is confirming that, in terms of the spine, the problem occurs when there is a fretting of metal from a loose implant component.

    If either of you want a copy of the protocol that he sent, send an email to me at lindaracine @ earthlink.net (without the spaces of course).

    Regards,
    Linda
    Last edited by LindaRacine; 10-27-2004 at 02:51 PM.

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