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Thread: Fusion medium/agent comparisons

  1. #16
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    Quote Originally Posted by titaniumed View Post
    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 don't agree at all. I can't tell you how many time I've heard someone say they were laying still in bed, or sitting quietly in a chair.

    I know you heard from the countless surgeons who spoke at support group meetings, that rods can be compared to paperclips. When bent back and forth a bunch of times, they weaken at a specific spot. Eventually, they just finally break. Strong rods that haven't been weakened by continuous stress do not just break.

    With that said, I agree that some weightlifting moves might be detrimental.

    --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

  2. #17
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    Quote Originally Posted by LindaRacine View Post
    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
    We talked about it up front. For some reason he didnt want to use my bone and that he was going to use some newer bone pastes of that era (2008) (Along with BMP Infuse kits)

    Once again, I guess I am fused.....

    Until I lift that 40# box out of the trunk or off the floor and hear that pop.

    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

  3. #18
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    Quote Originally Posted by LindaRacine View Post
    I don't agree at all. I can't tell you how many time I've heard someone say they were laying still in bed, or sitting quietly in a chair.
    The rods could be 90% of the way to failure during recovery, then you fuse and all is good, wait a few years, crack your fusion, then it takes a week to complete the rod breaking process, or the final 10% and this happens in bed. Who is really going to know the failure rate?

    And of course, I guess it all depends on what you are doing in bed. (scoliosis forum humor)

    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. #19
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    I've also known plenty of patients who had broken rods and didn't know it.
    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. #20
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    Quote Originally Posted by LindaRacine View Post
    I've also known plenty of patients who had broken rods and didn't know it.
    Yes, very interesting that the rod or rods can break not even know it, and it takes soft tissue inflammation to trigger off the pain.

    There have been a few rod breakers over the age of 50 here over the last year. These testimonials are from people that made it through their surgeries ok, and many years later these problems arise. You have to wonder why such a delay? I dont believe that one goes 7 years and then lifts the heaviest amount of weight or creates the highest force thus breaking their fusions. What is really happening? Does the fusion material degrade with age?

    I think its best to clip the heavy weights off and limit to 10# over age 60. Heavy weights really dont get you anywhere anyway unless you really need it. For example my legs from skiing were huge back in the day, you need strong legs for the G forces in skiing hard. My workouts in PT were done all with light weights under 5#

    Lifting a 40# box off the floor is not a great idea at our age. I will either get somebody else, or pull the contents out of the box and do multiple trips. Its just not worth taking the chance.

    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. #21
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    Quote Originally Posted by titaniumed View Post
    Yes, very interesting that the rod or rods can break not even know it, and it takes soft tissue inflammation to trigger off the pain.

    There have been a few rod breakers over the age of 50 here over the last year. These testimonials are from people that made it through their surgeries ok, and many years later these problems arise. You have to wonder why such a delay? I dont believe that one goes 7 years and then lifts the heaviest amount of weight or creates the highest force thus breaking their fusions. What is really happening? Does the fusion material degrade with age?

    I think its best to clip the heavy weights off and limit to 10# over age 60. Heavy weights really dont get you anywhere anyway unless you really need it. For example my legs from skiing were huge back in the day, you need strong legs for the G forces in skiing hard. My workouts in PT were done all with light weights under 5#

    Lifting a 40# box off the floor is not a great idea at our age. I will either get somebody else, or pull the contents out of the box and do multiple trips. Its just not worth taking the chance.

    Ed
    Ed....

    I honestly think it's the paperclip thing. You never know if/when that paperclip will break. Sometimes it break after 3 or 4 bends and other times it might take a dozen bends. I've heard surgeons speculate that someone's rods might weaken in the early post-op recovery period, and that the patient goes on to have a solid fusion, and have the rods eventually break due to the minute amount of movement that even a solid fusion allows.

    --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

  7. #22
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    Quote Originally Posted by titaniumed View Post
    I am concerned with activites that break rods.


    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
    The newsletter of my local hospital featured a woman in her 60's with osteoporosis who greatly improved her condition by dedicatedly pumping iron. She did not have a fused spine, I presume. I have heard elsewhere that this can help, too.

    Yeah, young people make me sick with their quick recovery times and resumption of normal activities. I realize there are limitations at my age.

  8. #23
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    Isn't it dangerous when rods break? Can't it puncture something internally?

  9. #24
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    Quote Originally Posted by LindaRacine View Post
    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
    I've heard that walking is good for osteoporosis, too. It seems less intuitive than allover strength building since it targets only the lower body. But bone density is fairly even all over the body, isn't it? They determined my bone density from my forearm alone.

  10. #25
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    Quote Originally Posted by Tina_R View Post
    Isn't it dangerous when rods break? Can't it puncture something internally?
    Never heard of that happening, but there’s always a possibility. Most times, the rods don’t move very much, as they’re usually anchored on one end. If a rod were to come loose if the construct, removing it would be a relatively easy surgery.
    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

  11. #26
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    Quote Originally Posted by titaniumed View Post
    These testimonials are from people that made it through their surgeries ok, and many years later these problems arise. You have to wonder why such a delay? I dont believe that one goes 7 years and then lifts the heaviest amount of weight or creates the highest force thus breaking their fusions. What is really happening? Does the fusion material degrade with age?

    Ed
    Hi Ed,

    I guess I am one of those people now. Broken rods at nearly 8 years post-op. My doctor believes I have nonunion at one or two levels. Apparently it took 7 years and 9 months of just slight movement against the titanium rods to wear them out. I did hear a slight pop, but I can't even remember what I was doing. Pain started a few weeks later. It turned out I have three breaks - and I only heard one. Looks like I'm headed for revision surgery, which will mean additional rods placed along T3-T4, where the breaks are. If I knew how to upload a photo, I'd post pics of the x-rays. BTW, the pain of broken rods for me is about the same as post-op, except it is actually worse than post-op when I am laying down. I think a nerve is pinched or something.

    Anyhow, getting back to the question that started this thread, I would certainly want them to use everything they can use for an initial lumbar fusion: allograft, autograft and BMP. Whatever makes a strong fusion! I'm not sure why they don't put multiple rods in everyone, really. At least at the most vulnerable levels. Interestingly, my break is right above where they put in BMP. I have heard the same from another person who had a late break. My guess is the BMP levels fused first, so all the tension/stress of movement went to the level above.

    P.S. I have tried and plan to continue to try very light free-weights to help with overall bone strength and health. 3-5 pounds.
    age 48
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
    Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
    Not "confused" anymore, but don't know how to change my username.

  12. #27
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    Quote Originally Posted by Confusedmom View Post
    Hi Ed,

    I guess I am one of those people now. Broken rods at nearly 8 years post-op. My doctor believes I have nonunion at one or two levels. Apparently it took 7 years and 9 months of just slight movement against the titanium rods to wear them out. I did hear a slight pop, but I can't even remember what I was doing. Pain started a few weeks later. It turned out I have three breaks - and I only heard one. Looks like I'm headed for revision surgery, which will mean additional rods placed along T3-T4, where the breaks are. If I knew how to upload a photo, I'd post pics of the x-rays. BTW, the pain of broken rods for me is about the same as post-op, except it is actually worse than post-op when I am laying down. I think a nerve is pinched or something.

    Anyhow, getting back to the question that started this thread, I would certainly want them to use everything they can use for an initial lumbar fusion: allograft, autograft and BMP. Whatever makes a strong fusion! I'm not sure why they don't put multiple rods in everyone, really. At least at the most vulnerable levels. Interestingly, my break is right above where they put in BMP. I have heard the same from another person who had a late break. My guess is the BMP levels fused first, so all the tension/stress of movement went to the level above.

    P.S. I have tried and plan to continue to try very light free-weights to help with overall bone strength and health. 3-5 pounds.
    All the additional implants and BMP add significantly to the cost of surgery (probably somewhere in the neighborhood of an additional $100K+). Also, there is a risk of cancer with BMP, so most surgeons only use it when there are significant risk factors for non-fusion.
    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

  13. #28
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    Evelyn, did Dr L do TLIF's on you? Just wondering? Did you ever get your hospital reports after your surgeries?

    You will need an experienced revision surgeon......its going to be up to him. Funny, they train scoliosis surgeons in Indianapolis, do you know about this? Maybe Linda knows. My secondary scoliosis surgeon was trained in Indianapolis. Dr Halki.

    ALIF or stacked ALIF involves 2 surgeries, front and back. These procedures can get extremely expensive as Linda mentioned.....

    You know if you think your going to need surgery at any point, adjusting your insurance policy is a must. I dont know what you have, but as a general statement, its important to be highly proactive months before our procedures. I had the best insurance I could afford and it WAS NOT CHEAP.

    On instructions for attaching photos, its here someplace, try search. If you cant find it, I will start my own thread so this doesnt get lost again.

    I have used NSAID's for pain for 18 years now. You could try Celebrex, or Diclofenac. Gabapentin is strong stuff, for nerve pain. Hot water soaks in a deep tub at 106 Degrees works well for pain. Measure it with a pool or hot tub thermometer. Drink a LOT of water if you do this, dont get dehydrated, you will cause more problems.

    Hang in there

    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

  14. #29
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    Quote Originally Posted by titaniumed View Post
    Evelyn, did Dr L do TLIF's on you? Just wondering? Did you ever get your hospital reports after your surgeries?
    Ed, Thanks for the tips! You are a champ. Can't believe you are still out here constantly supporting the scoli community. You and Linda. Thank you!!!

    I think I had TLIFs. I guess I don't know what technically qualifies as a TLIF. But I can tell you that my surgery was all posterior, and I do have some cages and BMP. A couple discs were removed. Does that answer the question? I did get hospital reports -- I have about 100 pages! I have been told by a couple of acquaintances that broken rods are not uncommon around the 7-year mark, and they don't know why. I'm guessing the titanium just wears out at that point if you didn't fuse.

    Regarding insurance: Thank God for that! We have a high deductible, but it pays 100% after we meet it. They are giving me a hard time about Tramadol, however. Not as free with the opioids as they were 8 years ago. Guess that's a good thing! But it is a little inconvenient when they make you get re-authorization from your doctor every seven days.

    Regarding pain: A friend on a Facebook page suggested a brace for pain. Has been the best advice! I am almost pain-free during the day now (while wearing a brace). But, I can't lay down or everything goes haywire. Seems like there is some instability back there. Which is not surprising given three breaks. Ahh well, here's to fixing things in February!
    age 48
    80* thoracolumbar; 40* thoracic
    Reduced to ~16* thoracolumbar; ~0* thoracic
    Surgery 3/14/12 with Dr. Lenke in St. Louis, T4 to S1 with pelvic fixation
    Broken rods 12/1/19; scheduled for revision fusion L1-L3-4 with Dr. Lenke 2/4/2020
    Not "confused" anymore, but don't know how to change my username.

  15. #30
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    Quote Originally Posted by Confusedmom View Post
    Ed, Thanks for the tips! You are a champ. Can't believe you are still out here constantly supporting the scoli community. You and Linda. Thank you!!!

    I think I had TLIFs. I guess I don't know what technically qualifies as a TLIF. But I can tell you that my surgery was all posterior, and I do have some cages and BMP. A couple discs were removed. Does that answer the question? I did get hospital reports -- I have about 100 pages! I have been told by a couple of acquaintances that broken rods are not uncommon around the 7-year mark, and they don't know why. I'm guessing the titanium just wears out at that point if you didn't fuse.

    Regarding insurance: Thank God for that! We have a high deductible, but it pays 100% after we meet it. They are giving me a hard time about Tramadol, however. Not as free with the opioids as they were 8 years ago. Guess that's a good thing! But it is a little inconvenient when they make you get re-authorization from your doctor every seven days.

    Regarding pain: A friend on a Facebook page suggested a brace for pain. Has been the best advice! I am almost pain-free during the day now (while wearing a brace). But, I can't lay down or everything goes haywire. Seems like there is some instability back there. Which is not surprising given three breaks. Ahh well, here's to fixing things in February!
    Yes, it sounds like you have TLIFs. Dr. Lenke used that technique frequently.
    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

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