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Thread: Fusion medium/agent comparisons

  1. #1
    Join Date
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    Fusion medium/agent comparisons

    Hi all, in light of considering a revision/additional fusion to my pre-existing one, a question has come to mind. If not using your own donor bone for fusion medium, are there greater non-fusion/non-union risks with donor bone or with synthetic analogs especially when fusing over a disc replacement? Any thoughts on different aspects of this?

    This would be in a younger patient with no personal or family history of DDD, soft tissue conditions, arthritis, or connective tissue conditions. Thanks!
    Feb 2003 - Diagnosed C (35) T (45) L (25)
    Dec 2003 - T2-T12 Fusion correcting to C (8), T (14), L (20)
    Oct 2019 - Lumbar curve progressed to 40
    Nov 2019 - Thoracic curve progressed to 31
    ??? 2020 - T10-S1 Fusion with SI fixation

  2. #2
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    Quote Originally Posted by JScoli91 View Post
    Hi all, in light of considering a revision/additional fusion to my pre-existing one, a question has come to mind. If not using your own donor bone for fusion medium, are there greater non-fusion/non-union risks with donor bone or with synthetic analogs especially when fusing over a disc replacement? Any thoughts on different aspects of this?

    This would be in a younger patient with no personal or family history of DDD, soft tissue conditions, arthritis, or connective tissue conditions. Thanks!
    I don't think this is anything about which you need to worry. Typically, there is enough extra bone in revision surgeries (at least for someone as young as yourself who is unlikely to suffer from osteopenia or osteoporosis), that biologic agents such as BMP are not required.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  3. #3
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    May 2008
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    reno,nevada
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    Autogtaft (Your bone) is the gold standard fusion material. It has been for over 100 years.

    They are also doing a stacked ALIF and fusing from the front and back which is a strong construct. I have never seen an ALIF patient break their rods.

    You could ask for your information.....young people dont usually break rods, and if they do its a rare thing. BMP is usually used on elder patients that might have trouble fusing. Infuse kits, they are also VERY expensive....

    Its time to party. Think I will have a yogurt. Ha ha

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

  4. #4
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    Quote Originally Posted by titaniumed View Post
    I have never seen an ALIF patient break their rods.
    It happens.

    https://www.researchgate.net/figure/...fig3_316055146
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  5. #5
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    Quote Originally Posted by LindaRacine View Post
    Linda, I had a feeling you were going to produce the goods.... OMG, those are heavy duty constructs on the dual rod group.

    Average age was 68 and 63. I dont know if we have any multi-rod members besides Susan.

    There is a 40 year difference in age....

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

  6. #6
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    Quote Originally Posted by titaniumed View Post
    Linda, I had a feeling you were going to produce the goods.... OMG, those are heavy duty constructs on the dual rod group.

    Average age was 68 and 63. I dont know if we have any multi-rod members besides Susan.

    There is a 40 year difference in age....

    Ed
    Satellite or supplemental rod systems are actually pretty common these days, especially in older people and in people who have previously broken rods.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  7. #7
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    Aug 2019
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    107

    Autograft

    Quote Originally Posted by titaniumed View Post
    Autogtaft (Your bone) is the gold standard fusion material. It has been for over 100 years.

    They are also doing a stacked ALIF and fusing from the front and back which is a strong construct. I have never seen an ALIF patient break their rods.

    You could ask for your information.....young people dont usually break rods, and if they do its a rare thing. BMP is usually used on elder patients that might have trouble fusing. Infuse kits, they are also VERY expensive....

    Its time to party. Think I will have a yogurt. Ha ha

    Ed
    Ed from what I have read they take autograft from your hip bone. But can also take bone from cadaver. Iím interested in this subject because I already have titanium hips. If you have donít have bone available in the hips where else would autograft come from? Rib? Also will be having ALIF & have osteoarthritis. Thanks Nancy

  8. #8
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    Quote Originally Posted by Scared View Post
    Ed from what I have read they take autograft from your hip bone. But can also take bone from cadaver. Iím interested in this subject because I already have titanium hips. If you have donít have bone available in the hips where else would autograft come from? Rib? Also will be having ALIF & have osteoarthritis. Thanks Nancy
    I've never heard of bone being taken from the actual hip. It's typically taken from the iliac crests, ribs, spinous processes, or from other spine bone removed for access.

    Bone taken from cadavers is allograft, not autograft.
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  9. #9
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    I remember watching an old Dr Winter video on VHS 40 years ago, and of course one of the first things was the removal of the spineous process on each level....They do this with a pair of pliers and they come off pretty easy. There is an assistant that holds a plate for collection. For my surgery all my facets were also removed, but that bone was not used.

    https://www.spine-health.com/treatme...ients-own-bone

    There have been patients that have complained about harvesting bone off the hip.(illiac crest) I remember specifically asking my surgeon about this and this method was not done on me. I had no bone used on my surgeries, it was synthetics and BMP.

    I guess I am fused since I have not broken any rods. I guess thats the acid test. I am almost 12 years post.

    I am NOT lifting anymore....No way, Jose. I am not taking any chances.

    Osteoarthritis or Osteoporosis? or both?

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

  10. #10
    Join Date
    Sep 2019
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    148
    Quote Originally Posted by titaniumed View Post
    I remember watching an old Dr Winter video on VHS 40 years ago, and of course one of the first things was the removal of the spineous process on each level....They do this with a pair of pliers and they come off pretty easy. There is an assistant that holds a plate for collection. For my surgery all my facets were also removed, but that bone was not used.

    https://www.spine-health.com/treatme...ients-own-bone

    There have been patients that have complained about harvesting bone off the hip.(illiac crest) I remember specifically asking my surgeon about this and this method was not done on me. I had no bone used on my surgeries, it was synthetics and BMP.

    I guess I am fused since I have not broken any rods. I guess thats the acid test. I am almost 12 years post.

    I am NOT lifting anymore....No way, Jose. I am not taking any chances.

    Osteoarthritis or Osteoporosis? or both?

    Ed
    What aren't you lifting? You mean lifting weights in the gym? Is that something you think a fully fused person shouldn't do?

  11. #11
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    Activites of Daily life with High Spinal Loads

    Lifting a weight off the floor while bending over produces a lot of force in the lumbar spine....I think if I wanted to break my rods, this would be the choice method.

    Holding an object in front of you comes in 2nd place.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035320/

    (1650 Newtons=371 pounds of force) 10.8 Kilogram box= 24 Pounds

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

  12. #12
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    Sep 2019
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    148
    Quote Originally Posted by titaniumed View Post
    Lifting a weight off the floor while bending over produces a lot of force in the lumbar spine....I think if I wanted to break my rods, this would be the choice method.

    Holding an object in front of you comes in 2nd place.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035320/

    (1650 Newtons=371 pounds of force) 10.8 Kilogram box= 24 Pounds

    Ed
    Are all weightlifting exercises off limits? What about bench press? Others I can picture but can't name.
    Ironically this is good exercise for osteoporosis.

  13. #13
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    Quote Originally Posted by titaniumed View Post
    I remember watching an old Dr Winter video on VHS 40 years ago, and of course one of the first things was the removal of the spineous process on each level....They do this with a pair of pliers and they come off pretty easy. There is an assistant that holds a plate for collection. For my surgery all my facets were also removed, but that bone was not used.

    https://www.spine-health.com/treatme...ients-own-bone

    There have been patients that have complained about harvesting bone off the hip.(illiac crest) I remember specifically asking my surgeon about this and this method was not done on me. I had no bone used on my surgeries, it was synthetics and BMP.

    I guess I am fused since I have not broken any rods. I guess thats the acid test. I am almost 12 years post.

    I am NOT lifting anymore....No way, Jose. I am not taking any chances.

    Osteoarthritis or Osteoporosis? or both?

    Ed
    Hi Ed...

    If you ever get the chance, you should ask your surgeon why he didn't use the spinous processes. Maybe they didn't have the device that morselizes the bone.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  14. #14
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    Quote Originally Posted by Tina_R View Post
    Are all weightlifting exercises off limits? What about bench press? Others I can picture but can't name.
    Ironically this is good exercise for osteoporosis.
    I've never been a weightlifter, but I probably wouldn't do any super heavy lifting. I don't recall, however, ever hear a surgeon say that a patient couldn't do it after the typical 3-6 month post-op restriction.

    While weight lifting is good for bone building, any weight bearing exercise, including walking, is also very beneficial.

    --Linda
    Never argue with an idiot. They always drag you down to their level, and then they beat you with experience. --Twain
    ---------------------------------------------------------------------------------------------------------------------------------------------------
    Surgery 2/10/93 A/P fusion T4-L3
    Surgery 1/20/11 A/P fusion L2-sacrum w/pelvic fixation

  15. #15
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    Quote Originally Posted by Tina_R View Post
    Are all weightlifting exercises off limits? What about bench press? Others I can picture but can't name.
    Ironically this is good exercise for osteoporosis.
    I am concerned with activites that break rods.

    It seems that lifting items "off the floor" and bending over, getting into lower cubboards are in the testimonials from the rod breakers....they dont break on their own, there is always that catalyst. "Yes, I was lifting, and then I heard the pop".

    I cant comment on "all weightlifting". The study has a few examples with values.

    There is or was a poster from England that was actually weight lifting years ago using bar bells and such. He was much younger, and it all worked out ok for him. As long as nothing breaks, thats all fine.

    At my age I am not going to gamble on the integrity of my fusions. I dont think its worth it.

    Another thing thats interesting is that it seems that younger fusion patients fare up better. They break less rods. Unless Linda or Sharon can find a study, I believe this is the case. I dont know the stats on what age group breaks the most rods. It would be nice if more younger posters posted here. The younger posters that have posted here in the past seem to do quite well (with fusion) and then we dont hear from them anymore. Jay Moe and Bendy Bill are our youngest recent posters.

    I didnt know there was a specific exercise for osteoporosis. If there was one for dementia, I would be all over that. (smiley face)

    Ed
    49 yr old male, now 61, the new 61...
    Pre surgery curves 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

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