What causes broken rods?

[Susie*Bee]

I keep running across posts that talk of broken rods and have been wondering what causes that to happen. I imagine many things can be responsible... but if any deal with "over-doing" and thereby causing stress on the rods, it sure would be good to know. I thought instead of just wondering some of you might be able to shed some light on the subject. Just looking for a little info here. Thanks!

[scoliboymom]

I can't answer your question but to add to it am wondering if the titanium rods have a greater tendency to break then stainless steal.

[LorDon]

Dr. Flynn only uses stainless steel because titanium is too flexible and tends to notch and break much easier.

After seeing a model of the spine with the instrumentation attached, it gave us a better perspective of just how strong those rods are. Dr. Flynn assured us that it would take a tremendous amount of force to break the rods. He has had a few kids break the screws, but never a rod. One kid who broke a screw was playing tackle football against his advice, so shame on him (and his parents) for not following doctor's orders!!!! IMHO, "overdoing it" can't cause a rod to break.

[CHRIS WBS]

It’s my understanding that a non-union can lead to rod breakage. Also, I personally think the longer the rod, the more susceptible it becomes to breakage. There’s a recent post here from a woman in Dallas whose rods broke, and she did have stainless steel rods.

Susie, Happy Birthday!

Chris

[Susie*Bee]

Thanks!

Thanks, Chris, for the birthday wishes. I'll have to change my "signature"-- and 57 somehow sounds a lot older to me than 56 did! Even so, ever since I had melanoma cancer at age 20, I am grateful for adding another year to the "marks on my belt." Back then I had real thoughts of not being able to live my life, get married, have kids, etc. And I feel blessed by all these years--and the riches of family and friends, and hopefully many more years to come!

And thanks, everyone, for posting what you know about rod breakage. Not something we want to think about, but if there is any way to prevent ANY of the causes, it would be good to know. Again, I think we are all strong in having gotten through surgery #1, and can deal with whatever comes our way, whether it's something like this or the need for more fusion or osteotomies (sp), or whatever. Any more thoughts out there?

[LorDon]

Happy Birthday Susie! Enjoy your day - hope you have something fun planned!

[LorDon]

Chris,
Any chance you remember whether the woman from Dallas explained the circumstances surrounding how the rods broke? I'd be interested to know.

[CHRIS WBS]

Here's her post http://scoliosis.org/forum/showpost....4&postcount=17

I asked her if she is a smoker and if she has osteoporosis as she is 65, but have not seen any response. As I observed my 85-year-old aunt this weekend, I noted that she has lost height and is somewhat bent over as many people are by that age. She has been taking Fosamax for years. But it made me stop and wonder how hardware will remain intact in our spines as we age and our bones soften.

Chris

[dalmatica]

Both of my titanium rods broke last spring and that has led to a drastic negative change on my life. I went from being super active, having a baby at 47, having a great career to crippled to the point of a walker. Both of my revisions failed and I am waiting on insurance to see if I go to Dr. Boachie for my next two (you read it right) surgeries or stay in Pittsburgh for them.

No, being active DOES NOT CAUSE THEM TO BREAK once the fusion is healed initially. I do know that the fusion usually breaks down first (psuedoarthrosis) then the rods break. One theory is that they now think that the titanium isn't such a good material for this surgery after all.

Sorry for the bad news but that's the way it is.

[txmarinemom]

Alternate materials ...

Ladies, 316L SS and titanium isn't ALL that's out there.

Hanson is planning Vitallium rods for me (a proprietary cobalt, chromium, moly alloy). I asked a bunch of geeky metallurgy questions because my background is oilfield manufacturing ...

I specifically questioned cyclical loading (i.e, how many cycles - at what load - consistently demonstrated load failure) and fatigue fracture (FRx) in an email to him when he told me what he planned to use.

This is what he wrote me back:

"Pam,

I haven't had any fatigue fracture with the Vitallium rods. As you know, there are two factors that come into play when evaluating the strength of
the material, both the material itself and the overall radius of the rods.

As the radius of the rod increases (SS is only available in 5.5 mm or 6.35 mm rods, versus 6.0 mm for the Vitallium) the overall strength of the rod goes up by a factor of 4. So, I think a 6.0 mm vitallium rod is a good compromise and certainly is quite strong.

I don't think that you would have any issues playing softball again as it
relates to the strength of the rod."

(oh, lol ... I guess I DID write him to determine whether I'd snap a rod going face first into home playing softball ;-)

Pam

[The Slice]

I think I'll add my "two cents" worth here and that's probably all it's worth . There are many variables here that are not known in any of the cases, but it's possible that it's a combination of a point of non-fusion, and the nature of the metal. The harder metal is made, for the most part, the more brittle it becomes. There has to be a balance between enough flexibility in the metal so that it doesn't snap, and hardness so that it holds it's shape until the bones fuse. I'm guessing that there are conceivably other factors such as just how much stress was put on the rods when putting them in. It's possible that the surgeon may have tried for just a little too much correction in the spine. It's not as if they necessarily did anything wrong, but it is. I imagine, largely a judgement call.

Suzie Bee, Happy birthday! I like you am a survivor, and it has gotten to be for me that I kind of celebrate two birthdays. I was born with a number of medical problems including what they thought was polycystic kidney disease (PKD), and an atrial septal defect. I didn't have surgery on the heart until I was almost nine. The reason being that in those days, heart lung bypass was still very new and most doctors were still using the old "cut and run" method where they chlled the body, stopped the heart. did the repair, and then started the heart again and closed. In my case, they presumed later that I did not have PKD, as the congenital form of it is almost guaranteed to be fatal. But because they thought it was PKD, they told my parents for the first ten days, not to name me, see me, or get attached as they were sure I was going to die. Attitudes were a lot different in the fifties then they are now. Since I survived those ten days, they said that I would probably not last more than a year. The lab values were still whacked out so they presumed that I had chronic renal failure which made the possibility of heart surgery all that much more risky, especially with the older techniques. In fact, The first hospital that my parents took me to for the heart surgery told them outright that they wouln't do it because they didn't want a death in their O.R. on their hands. Well physically everything worked out. It turned out that the one working kidney that I did have was, and is, working fine, What was wrong was that there was a narrowing in the ureter from the kidney to the bladder causing retention of urine in the kidney. Long story short, I've come to appreciate what a survivor I really am, and because of that, I think I have at least a little bit of an idea how you feel.

Txmarinemom, Good luck on your surgery, and I hope that all goes well and that you have a speedy recovery. I hope you can forgive me for having both feet in my mouth before. So far as I'm concerned, I don't judge people by their appearance, but who they are on the inside. I don't know you other than what I've seen of your posts, and what I see is a wonderful person who has a lot of self confidence, and a fantastic sense of humor, and wit. Thank you for the laughs you've given me as well as the others.

[Susie*Bee]

Wow, Slice!

Talk about a survivor! You're a walking miracle! I'm so glad that you were able to prove all those doctors "wrong"! In general, I admire the medical profession and applaud how far they've progressed, but they still have such limitations... Thanks for your insights and caring/concerned posts.

And yes, Pam, he summed up your positive attributes so well in those last couple of sentences. You are a jewel to the forum. I'll be praying for you next Tuesday and beyond. And hey, did you notice today that on the main forum page, if you scroll to the bottom--where the birthdays are listed, there's a section on events and it shows today's surgery...

[txmarinemom]

Aw ... thanks guys ;-)

Very sweet of y'all to say, and Slice, no worries ... water under the bridge.

Regards,
Pam

[CHRIS WBS]

More on broken rods from our friend Dr. Hey
http://drlloydhey.blogspot.com/2008/...-revision.html
Looks like a good fall can do it.

Chris

[txmarinemom]

More on broken rods from our friend Dr. Hey
http://drlloydhey.blogspot.com/2008/...-revision.html
Looks like a good fall can do it.

Chris

That's too bad for some. My doctor is telling me I can go back to diving after balls and sliding into bases at 4 months post op.

And I have every intention of meeting that goal (and not living my life after surgery in fear)!

Regards,
Pam