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Thread: What causes broken rods?

  1. #16
    Join Date
    Sep 2007
    Location
    NJ
    Posts
    131
    Pam,
    Refresh my memory because I'm too lazy to go back and sift through all of your posts - why is Hanson using Vitallium and does he use it on all of his patients?
    Lori

    Mom to Christopher, age 17, Mark, 13, Heather, 10 and Michael, 8
    Chris had surgery with Dr. John Flynn at Children's Hospital of Philadelphia on December 12, 2007. He is fused T4 to L4.
    Dr. Flynn is an AMAZING surgeon!

  2. #17
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    It's simply what he prefers ... strong and lightweight (all hardware combined should weigh in ±6 oz.)

    One thing he really likes about it is it's MRI-able. I'm not sure if he uses it on all his patients (especially those at Shriners), but I can shoot him an email and ask!

    Regards,
    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op ±53°, Post-op < 20°
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  3. #18
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    Vitallium is NOT cheap, BTW, and as macabre as it may sound, I've seriously considered (I'm donating my body to science ... um, hopefully not any time soon!) to whom I should bequeath my hardware in my will ;-).

    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op ±53°, Post-op < 20°
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  4. #19
    Join Date
    Oct 2007
    Location
    Indiana
    Posts
    1,974
    Yes, it's really pricey! I wondered if I could have a screw for "show and tell"-- and was told they run $2000 each. I have 17, so I'm a pretty valuable person. I don't know how much the rods run though. I'm pretty sure mine are steel--didn't really care/pay that much attention. But I do know they said none of the hardware would cause a problem with any future MRIs.
    66 and still heartbroken...
    2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15°
    2014 DXd w/CMT (type 2)

    Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

  5. #20
    Join Date
    Jul 2005
    Location
    California
    Posts
    269
    When I had my most recent revision my surgeon decided to use titanium over stainless steel so that if I needed an MRI in the future I could have one. With my history of disc problems, nerve pain, etc. it helps to be able to use MRI if needed!

  6. #21
    Join Date
    Jan 2008
    Location
    Wisconsin
    Posts
    15
    Broken rods occur when the back fails to fuse known as pseudoarthrosis. I'm 19 and had surgery when I was 17. Recently one of my stainless steel rods broke. I have seen two different doctors since that both of whom assured me that nothing I did or didn't do caused this but if its going to happen its going to happen no matter what I do.

    One surgeon described breaking the rod like breaking a paper clip. If you try to break a paper clip it won't by just bending it once but if you move it back and forth over and over again it will break. Essentially this is what happens to the rods. Because the back doesn't fuse it pushes and pulls on the rod. Since it is a metal rod about as thick as a pencil, it takes about a million times to break it which equates to a year or two.

    I don't smoke and was pretty careful about what I did after surgery. This summer I will be having a revision surgery to put new rods in and refuse the parts that didn't fuse because I'm in a lot of pain. Hope this helps.

  7. #22
    Join Date
    Oct 2007
    Location
    Indiana
    Posts
    1,974

    Thanks!

    Thanks for the input, everyone! I think it's interesting that we seem to have different info on MRIs...

    iluvmath!--sorry you have to have another surgery. I knew that pseudoarthrosis could cause rod breakage, but didn't know if other stresses could also serve as catalysts... By the way--I have a daughter in college who also loves math way beyond belief... you math-lovers are an enigma to so many of us! Where do you go to college?
    66 and still heartbroken...
    2007 52° w/ severe lumbar stenosis & L2L3 lateral listhesis (side shift)
    5/4/07 posterior spinal fusion T2-L4 w/ laminectomies and osteotomies @L2L3, L3L4
    Dr. Kim Hammerberg, Rush Univ. Medical Center in Chicago

    Corrected to 15°
    2014 DXd w/CMT (type 2)

    Click to view my pics: pics of scoli x-rays digital x-rays, and pics of me

  8. #23
    Join Date
    Sep 2005
    Posts
    877
    I am so sorry you have to have another surgery. I hate hearing that especially because my daughter just had surgery. May I ask if you had a very experience surgeon and where did you get it done? I thought it was pretty rare for this to happen in 2007.
    Melissa
    From Bucks County, Pa., USA

    Mom to Matthew,19, Jessica, 17, and Nicole, 14
    Nicole had surgery with Dr. Dormans on 9/12/07 at Children's Hospital of Phila. She is fused T-2 - L-3

  9. #24
    Join Date
    Jan 2008
    Location
    Wisconsin
    Posts
    15
    I go to the University of Wisconsin Stevens Point...I'm actually studying to be a high school math teacher.

    I had my surgery in Milwaukee with Dr. Thometz. He is a very highly respected surgeon and is head of orthopedics at Children's Hospital of Wisconsin. I have seen other doctors about my problem and they have all said that it was nothing that Thometz did...some people just seem to have a hard time fusing bone compared to others. They did use donor bone during my first surgery instead of taking bone from my hip like they do for most people. I've been told that adults don't fuse donor bone. Since I was 17 when I had the surgery, I was at an age where it was borderline whether or not to use donor bone or not. I've been told that this might have been part of the problem so this time they'll be taking bone from my hip.

  10. #25
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    iluvmath ....

    I'm curious. The combination of allograft and BMP is now touted as the fastest fusion. When did you have your surgery? Who told you adults didn't do well with allograft? (*especially* with BMP)

    Regards,
    Pam
    Last edited by txmarinemom; 02-01-2008 at 04:19 AM. Reason: DOH! ... additional questions ... this is SUCH a silly field. Is someone tracking reasons??
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op ±53°, Post-op < 20°
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  11. #26
    Join Date
    Jan 2008
    Location
    Wisconsin
    Posts
    15
    One of the surgeons that I met with (he's an adult scoliosis specialist) is actually the one that told me that adults have trouble fusing allograft (donor bone). It's possible that this is only applicable if not also using BMP because I know that was not used when I had my first surgery.

    I had my surgery almost 3 years ago...I'm not sure if BMP was widely used back then or not. All the surgeons that I have met with have mentioned that they would use it this time around.

  12. #27
    Join Date
    Jun 2007
    Location
    DFW area of Texas
    Posts
    72

    Hey Chris WBS - I'm the Dallas woman

    It's so nice to be remembered. I am Diane W, living in the Dallas Area, and had the fifth surgery (4th revision) on January 28th, so I'm a month out now and still in the recuperation period. To answer your two questions right away, I was a smoker until 1993, when I quit after smoking close somewhere around 30 years (oh, I hate that!) and only just recently, was told I have osteoporosis. For the last couple of years, I was just on the other side - osteoperina. My mother has 6 sisters, and all 7 of them have osteoporosis. They are in their 70's and 80's. So I don't stand much of a chance.

    I asked Dr. Viere and his PA, Linda, to save the hardware for me; that I had an idea to have the broken rods tested. When I went back to see Linda at the 2 week checkup, she handed me two sealed packages and I was literally shocked at the sheer volume and the weight of the hardware. Last summer, I broke both stainless steel rods in the lumbar area and Dr. Viere operated on September 10th. Then on November 30th, he released me to go back to work, and he left town on vacation. In about 10 days, I started hurting pretty bad and made an immediate appointment with Linda. As you know you are Xrayed the moment you enter the doctor's office, and she came back into the examining room, saying "well, we know why you're having so much pain!" "Your rods are broke". This time they had broke just above my waistline. I had to stop all activity and basically go to bed. Dr. Viere returned from vacation on Jan 2 and they gave me an appointment on Jan 4th. At surgery, what he did was take down all of the repair he did in September in the lumbar and make one large continuous repair with the new broken area. What was done differently this time was that he used bone morphogenic protein (BMP), and harvested local autogeneous bone graft cancellous chip - this was from T11 to L1.

    Thus, the heavier of the two packages contains the hardware from the September revision along with the broken pieces (stainless steel) from the recent breaks. The lighter package they saved back in September and it contained only the broken parts taken when they did the September revision. I read somewhere in here that someone's doctor mixed SS with Titanium. My doctor says that's not done. He usually uses Titanium, although SS is stronger.... Titanium is more flexible.

    Someone asked what causes rods to break. I've asked this a dozen or more times. Someone here said exactly what I've been told by the doctor - when the non-fusion of the fusion occurs, it leaves the rods in an unprotected state and not having anything to hold them steady, they bend back and forth. I suppose if we counted how many times we still bend, we would truly be amazed, and we're supposed to be the ones being careful. All in all, I'm left with the conclusion that the rods are not defective, and don't plan to have them tested. I talked to Linda about it, and she doesn't think they are either... she said they see a LOT of broken hardware.

    I am amazed at holding one of these packages in my hands, and multiplying its volume of hardware and its weight by about five or six - which approximates the length of my spine from T11 to L1, 2 or 3. Without this hardware, I suppose 'd just weigh nothing at all. LOL

    I want to learn more about BMP - can someone direct me to a website ?? When Dr. V first told me he had used it, I thought it was still in trial studies, but that's not true - it's been out perhaps five years.

    When I see Dr. Viere on the 11th, he's sending me for a catscan to see how much bone growth I've got, and if there's not enough in his opinion, he plans to go in through the front and put the BMP on the opposite side of the places he's trying to fuse. The good news is that in his operating report, he states he was pleased to see many areas of good bone fusion. If we have to do an anterior surgery, I want it done right away, so that maybe its aftermath can be counted in the initial 4-month recovery that Dr. Viere likes. I need to get back to work!! This is 5th time I've been gone. I'm very bored.

    One last thing - I would never have believed it, but each surgery is getting easier and easier. I heal quicker, I don't hurt as bad, I can move around that first day pretty darn well, even walk down the hospital hall a short ways. But the hospital food just gets worse and worse. I think I'm going to start carrying sack lunches.

    Yes, I am 65, but other than the back problems, I'm extremely healthy, with excellent heart and lungs, circulatory, and all the good stuff.

    My time is getting short on the next doctor's appointment and I want to know more about the BMP. If someone knows of a place, please also email me at dianabana@tx.rr.com

    Thank you for reading and if you can help me on learning more about the BMP, I'll be very grateful.

    Diane
    Diane in Dallas
    Adult Ideopatic Scoliosis (37%) and Kyphosis (65%)
    Surgery #1 8/4/03 - Dr. Shelokov, Plano
    Surg #2 12/8/03 - Dr. Shelokov, Plano
    Surg #3 1/10/05 - Dr. Shelokov, Plano
    Surg #4 9/10/07 - Dr. Viere, Dallas
    Surg #5 1/28/08 - Dr. Viere, Dallas
    Surg #6 4/27/09 - Dr. Viere, Dallas

  13. #28
    Join Date
    Nov 2007
    Location
    Big Bear, CA
    Posts
    290
    Hi Diane,
    If you Google bone morphogenetic protein there are lots articles on the subject. My surgeon used a combination of BMP and my own bone taken from the spineous (sp) process and transverse process of my spine. I still don't know how well the fusion took but am looking forward to my next appointment in about 4 weeks to find out! Good Luck and Stay Strong!
    Alicia
    Geish
    47 years old, dx at 13
    +30* to the right, +60* to the left, +30* to the right
    Surgery 12-13-07 - fusion from T4 to sacrum.


    http://www.scoliosis.org/forum/attac...tachmentid=267 Pre surgery
    http://www.scoliosis.org/forum/attac...tachmentid=268 Post surgery
    http://i156.photobucket.com/albums/t...s/DSC01091.jpg Xray from the side
    http://i156.photobucket.com/albums/t...1089-1-1-1.jpg Xray from the back

  14. #29
    Join Date
    Nov 2007
    Location
    Houston, TX
    Posts
    1,757
    Quote Originally Posted by Diane BCSW
    I want to learn more about BMP - can someone direct me to a website ?? When Dr. V first told me he had used it, I thought it was still in trial studies, but that's not true - it's been out perhaps five years.
    Yes, surgeons have been using it in conjunction with either allograft or autograft for a few years with scoli surgery, but it's not *technically* approved by the FDA for the manner in which they use it.

    That's how insurance companies (mine included - PHCS) get through the loophole of denying coverage ...

    BTW, they ought to codename this stuff "Pretty Amazing Sh**" because it cuts complete fusion healing time down from a year to 2-3 MONTHS. You'd THINK insurance companies (oops! ... there I go applying logic again ...) would see the value in less time to fuse/less chance of fusion damage. That's a LOT more expensive to fix than just paying for BMP up front.

    If you look at my surgery photos you can see what it looks like ... it just resembles white sponges. They mixed mine with allograft, and at my 3 week post op (last week) Hanson said it's all looking good ;-).

    Regards,
    Pam
    Fusion is NOT the end of the world.
    AIDS Walk Houston 2008 5K @ 33 days post op!


    41, dx'd JIS & Boston braced @ 10
    Pre-op ±53°, Post-op < 20°
    Fused 2/5/08, T4-L1 ... Darrell S. Hanson, Houston


    VIEW MY X-RAYS
    EMAIL ME

  15. #30
    Join Date
    Oct 2005
    Location
    Chicago north suburb
    Posts
    774
    Diane,

    Thanks for the update and letting all of us know how you are doing. I was hoping to see a happy face beside surgery #5. Let’s hope this is the last for you. Good healing and God bless.

    Chris

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