Page 1 of 2 12 LastLast
Results 1 to 15 of 17

Thread: stainless versus titanium

  1. #1
    Join Date
    Oct 2012
    Posts
    39

    stainless versus titanium

    What is everyones experience with stainless versus titanium. We have a few opinions for our son most are saying they use titanium but one(a very well respected surgeon at Shriners) uses stainless. We have some concerns about stainless mostly the risk of hypersensitivity. I would love to hear anyones thoughts on this issue, it might really help us make a descision about which direction to go.

  2. #2
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,795
    Hi...

    You might want to do a search of the forums, as there have been several threads on this topic.

    At the risk of boring people to death by saying this one more time... don't worry about what type of implants you'll get. Find a surgeon that you like, and you feel you can trust, and let him/her decide what's best. I think it's a bad idea to either choose a surgeon based on something so incidental, or even worse, influence a surgeon to use implants they don't normal use. Even if you choose a rookie surgeon, they're going to have a lot more knowledge than most of us could ever comprehend.

    Regards,
    Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  3. #3
    Join Date
    Mar 2005
    Location
    Ukiah CA
    Posts
    891
    Hi im hypersensitivity to not really well made types of metal but i have stainless steel rod and i dont hae a problem with it.
    Kara
    25
    Brace 4-15-05-5-25-06
    Posterior Spinal Fusion 3-10-10
    T4-L2
    Before 50T
    After 20T

  4. #4
    Join Date
    Jun 2011
    Location
    Southern CA
    Posts
    2,224
    Quote Originally Posted by LindaRacine View Post
    Hi...

    You might want to do a search of the forums, as there have been several threads on this topic.

    At the risk of boring people to death by saying this one more time... don't worry about what type of implants you'll get. Find a surgeon that you like, and you feel you can trust, and let him/her decide what's best. I think it's a bad idea to either choose a surgeon based on something so incidental, or even worse, influence a surgeon to use implants they don't normal use. Even if you choose a rookie surgeon, they're going to have a lot more knowledge than most of us could ever comprehend.

    Regards,
    Linda
    Linda is so right on this matter. When you have a surgeon whom you like and trust, you let them make the decisions
    Melissa
    Melissa

    Fused from C2 - sacrum 7/2011

    December 8, 2014 - Another Broken Rod Surgery

  5. #5
    Join Date
    Oct 2012
    Posts
    39
    Thanks everyone, that is really helpful. I was really concerned about sensitivities to stainless since we have many sensitivities in our family. I was somewhat letting this issue cloud our decision regarding a surgeon so it is good to know it does not matter that much!

  6. #6
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,795
    I have metal sensitivities as well, but have had stainless steel implants for about 20 years without problem. It's pretty rare that someone has a problem with the implants. When there is a problem, I think it's almost always because a rod doesn't get locked down under a screw properly, and some movement allows for fretting of the metal into the surrounding tissue.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  7. #7
    Join Date
    May 2009
    Posts
    3,745
    is there any way to do a test for allergy to certain metals before surgery...????
    when i was discussing surgery, which i didn't end up having, surgeon liked stainless, said he would use titanium when i requested it....that was several years ago...he may have changed his preferences by now...i will see him October 25th and will ask him what he now prefers (if i remember)

    jess...& Sparky

  8. #8
    Join Date
    Oct 2012
    Posts
    39
    Maybe we will try to check for allergy before the surgery. We have several opinions. Dr. Hammerberg at Shriners uses stainless, and Dr. Mardjetko's nurse said he uses titanium and she thought that is what everyone uses. I know this shouldn't be a big concern, but for some reason I am worried about it. I guess because me and my other children are very hypersensitive. Linda it is great hear that you are sensitive but have not had any problems, very reassuring.

  9. #9
    Join Date
    Sep 2003
    Location
    Northern California
    Posts
    6,795
    When I had my first surgeries 20 years ago, some patients were told to tape a nickel to the underside of the forearm for a few days. Out of curiosity, I tried it, and had an allergic reaction within the first day. My doctor didn't feel strongly enough about the issue to change from stainless to titanium, and it didn't bother me.

    While titanium has a huge benefit in terms of being able to have MRIs of the spine, the downside is that titanium is quite a bit more brittle. When we see broken rods at UCSF, they're usually titanium.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Dilbert
    I'm sarcastic... what's your super power? --Unknown
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    If you've signed up and are having trouble posting, please check your spam folder. An email was sent to the email address which you subscribed. You have to follow the instructions in that email. Done that and still having trouble posting? Contact Joe O'Brien at jpobrien@scoliosis.org.

  10. #10
    Join Date
    May 2008
    Posts
    169

    Message

    I have had stainless steel for about 46 years and the rods themselves have been fine, just really frustrating with the Xrays and MRIs and Linda honestly I did not realise that until I read your post why??, wow its good to be on the ball like me, that is a huge joke, oh dear. Thank you Linda, now I understand.

    Lorraine.
    Operated on in 1966, harrington rods inserted from T4 to L3, here in Australia. Fusion of the said vertebrae as well. Problems for the last 14 years with pain.
    Something I feel deeply,"Life is like money,you can spend it anyway you wish, but can only spend it once.

  11. #11
    Join Date
    Oct 2011
    Location
    East Central FL
    Posts
    192
    We had thought titanium was the way to go until our surgeon told us that chromium cobalt was his choice, that stainless & titanium would bend one way, but if you then bent it the opposite way there was tendency to break. That especially struck a chord with having a very active teen boy.
    Mom of 14yo son diagnosed Oct 2011
    Surgery 1/3/12 w Dr. Geof Cronen,
    Tampa General Hospital T3 to L1
    Jacob's pre surg curves: T58 & L31 12/28/11
    photos & xrays in "First-Time Surgery" thread "Before & After"

  12. #12
    Join Date
    Oct 2012
    Posts
    39
    interesting, I have never heard of the cobalt, but do have an active teenage boy, so I wonder if our doc would consider it.

  13. #13
    Join Date
    Jan 2012
    Location
    Yacolt, WA
    Posts
    1,525

    Article on internet about surgical stainless steel used in orthopedic surgeries

    Stainless steel in bone surgery.

    Disegi JA, Eschbach L.


    Source

    Synthes Technical Center, West Chester, Pennsylvania, USA.


    Abstract

    Today, stainless steel is one of the most frequently used biomaterials for internal fixation devices because of a favorable combination of mechanical properties, corrosion resistance and cost effectiveness when compared to other metallic implant materials. The biocompatibility of implant quality stainless steel has been proven by successful human implantation for decades. Composition, microstructure and tensile properties of stainless steel used for internal fixation is standardized in ISO and ASTM material specifications. Metallurgical requirements are stringent to ensure sufficient corrosion resistance, nonmagnetic response, and satisfactory mechanical properties. Torsional properties of stainless steel screws are different from titanium screws. Stainless steel bone screws are easier to handle because the surgeon can feel the onset of plastic deformation and this provides adequate prewarning to avoid overtorquing the screw. New nickel-free stainless steels have been recently developed primarily to address the issue of nickel sensitivity. These stainless steels also have superior mechanical properties and better corrosion resistance. The Ni-free compositions appear to possess an extraordinary combination of attributes for potential implant applications in the future.

    Susan
    Adult Onset Degenerative Scoliosis @65, 25* T & 36* L w/ 11.2 cm coronal balance; T kyphosis 90*; Severe disc degen T & L stenosis

    2013: T3- S1 Fusion w/ ALIF L4-S1/XLIF L2-4, PSF T4-S1 in 2 surgeries
    2014: Hernia @ ALIF repaired; Emergency screw removal surgery for Spinal Cord Injury at T4,5 sec to PJK
    2015: Revision Broken Bil T & L rods and no fusion: 2 revision surgeries; hardware P. Acnes infection
    2016: Ant/Lat Lumbar diskectomy w/ 4 cages + BMP + harvested bone + prayer

  14. #14
    Join Date
    May 2008
    Location
    reno,nevada
    Posts
    3,535
    Years ago, before the Harrington rod was invented (approx 1960) they didn’t use rods to hold the spine, they used casts. The invention of the Harrington rod was mainly for polios, that would twist beyond belief. Something had to be done. Dr Harrington approached Stryker to make the Harrington rods, which were made of 316L.

    316L was invented about 100 years ago..... They invented many steels during that time, but machining back then had its own set of problems....Carbide had just been invented by Kennametal (1938), and its quality at that time wasn’t that great. It was horrible actually, but a start. Titanium was on the scene also way back then.
    http://www.kennametal.com/kennametal...s/history.html

    Titanium and its alloys require good carbides to cut, this carbide technology only really advancing in the last 20 years or so. I used to call some of the carbides back in the 80’s “plastic carbides” since they didn’t perform all that well. The carbides today, and their “coatings” have improved substantially. Machining of Titanium many years ago was problematic.

    All the implant materials, 316LVM, Vitallium, Cobalt Chrome, and Titanium alloys have been around for many decades....and have been used for many decades. I have read that Vitallium was used for dental implants in Switzerland in the 30’s.

    Now, with the history covered of some of the implant materials, and manufacturing issues, the one thing that stands out is the fact that no matter what material is used, if a non-union or pseudarthrosis happens, any metal WILL break. Just like bending a paperclip back and forth it will eventually break. I have read 1 million cycles, it doesn’t take long. Now we know that “fusion” is an important goal. This takes months to happen.

    Corrosion can happen....Even 316LVM rusts, we saw this in a post here a few months ago where rods had to be removed from a 12 year old girl. I couldn’t believe the photos her mom posted....Titanium’s best qualities are its anti-corrosiveness. It has a Titanium oxide surface layer, that somehow limits this from happening, but at joints there is no guarantee. They also anodize titanium and use coatings and do testing in labs, but its not the same as body fluids in humans, and we are all different. It’s a complicated biochemistry problem.

    Titanium has better results in MRI machinery. 316 implants result in bright halos and make post operative viewing a problem. Ti6-Al-4V is not the choice titanium alloy and some have dropped the Vanadium..... The implants I have are Synthes Pangea system which is made from Ti-6Al-7Nb. Its been 5 years now...and no problems. I sometimes have sneezing fits, but not going to bother testing for titanium allergy.

    Surgeons have to go through learning curves with different hardware systems, there are so many now. The amount of associated tooling, tools, fixtures and devices doesn’t seem to end. Amazing that they have thought of everything! Each hole was drilled, reamed, and tapped, and each screw was tightened to 15nm with a torque screwdriver. 6mm is the size of my screws and rods, just slightly under 1/4” dia. They have screws up to 9mm in case they need them.

    The FDA controls Medications and Devices. They do not control surgeons, and they can use any system or surgical method they feel is best for the patient. You really want to be comfortable with your surgeon, and trust his expertise on hardware system and material selection. I am not aware of any new coating processes on 316, so cannot make an informed decision at all. This is up to the biomedical engineers. I would not dictate what material or system you want, the research required, the chemistry, and biochemistry is mind blowing. It never ends, and new technology continues on every day.

    It would be good to get a hold of David Wolpert’s book. It’s a mandatory read for scoli’s
    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  15. #15
    Join Date
    May 2008
    Posts
    169
    Ed, that was really really interesting thank you so much. makes me wonder what is happening to my stainless steel as MRIs and anything they try do not give an accurate assessment on what is going on.

    Ha ha I will just creak around the place and see what happens, but seriously thank you again for the info.

    Lorraine.
    Operated on in 1966, harrington rods inserted from T4 to L3, here in Australia. Fusion of the said vertebrae as well. Problems for the last 14 years with pain.
    Something I feel deeply,"Life is like money,you can spend it anyway you wish, but can only spend it once.

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •