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Old 02-09-2005, 11:59 AM   #1
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injured betty HB User
Mel, regarding failed back fusions

Part one:

I am not going to hijack that other person's thread anymore and will address your concerns here, no one else needs to read them unless they want to.


There are many, many mitagating factors in regards to the success or failure of fusions. Your points are well founded. General health is a number one concern. If you smoked, your success rate goes down. If you still smoke, it drops dramatically. If you are overweight, that may be one of the reasons one (as in the univeral one, not you) ended up with a back injury. A thin person is just as likely to end up with a back problem if they did not take care of their back, abs, and health. Your abs are the core of your body and it is one of the determing factors in general back health. One can stave off back problems their entire life by keeping in shape. Body builders do it everyday. When a person injures their back, the doctor usually finds that the abs are not in shape. A person needs to make abs a number one priority to prevent back problems and to prevent further back problems after fusion.

Genetics play a huge role in this. I was born with some abnormality that does not allow my skin to bind and heal at the same rate as others. Some people heal just fine. If I broke a bone, I am not sure how it would heal. Thankfully, I have never broken a bone, but breaking a bone is along the same lines as fusion, the body is trying to grow new bone, mend it so to speak.

Diet and health play a HUGE part in the fusion process. As I have stated before, my husband had to cut out soda (it sucks the calcium from your body). Look at kids with bad teeth and as soda drinkers. I have pepsi lines in my teeth from years of drinking that poison and quit about ten years ago. He had to give up chocolate. The caffiene inpeded bone growth. The old saying, "drinking coffee will stunt your growth" is not just an old wives tale. A healthy well balanced diet contributes to the fusion process plus it never hurt anyone.

Exercise, exercise, excercise, be it in the form of walking, stretches, PT, aqua therapy, any type of movement that gets the heart rate up and gets the blood flowing promotes bone growth. It is very important.

Think back to being a kid. Everything that they told you to do, in order to have healthy teeth and bones, now applies to the fusion process.

As for hardware: There are many types of hardware, rods, plates, screws, sponges, cages, etc. And, those come in many different types of materials. Titanium would be the top. It is pretty indestructible. Then there are many types of implants for the discs, ADRs, bone marrow from the patient, cadaver bones, bone from the illiac and BMP.

Insurance companies determine which method is used as well as the doctor. There are many, many checks and balances along the way.

Age plays a huge part in this process. Say my 100 year old grandmother had a back problem. They are not going to do an ADR, even though she has the cash and insurance to back it up. If a child needed a back fusion, they may not do as much for them as an older person because their bones are still growing and developing and they are a much better candiate for the fusion process.

Granted, we can't post web sites, but I will go on the hunt for the most comprehensive site, that addresses the actual issue of one type of fusion as opposed to another and put it in my own words.

Off to hunt,

 
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Old 02-16-2005, 01:39 PM   #2
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Re: Mel, regarding failed back fusions

Betty, I hadn't seen this since I wasn't on for so many days when my mom was visiting. I really dont' know what my dr did so even for me to try and back up what I think was done isn't really a good idea. For all I know I had all the other things done. I was planning on gettin some more info on my visit next week just to know-of course, I will have my med records too. I think there are so many factors involved that the important thing is that we do all we can to have the best chance for success. I was in great shape with strong abs, but yeah, smoked. I don't now but that doesn't mean it still won't inhibit my success. Based on how I feel these days, I'd say I am doing well, though won't really know for another month. I have to see my dr next week with another xray so I'll let you know how I am faring. Thanks for starting this thread, I don't like hijacking other posts either. Talk to ya soon!

 
Old 02-16-2005, 06:46 PM   #3
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Re: Mel, regarding failed back fusions

Mel, I meant to get back to you but have not had time to do the seach yet and even though I have it bookmarked, I don't sit for more than five minutes at a time on the computer. I will get to it though.

I am sure that you will be fine. You are young.

take care,

 
Old 02-16-2005, 11:28 PM   #4
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Re: Mel, regarding failed back fusions

dont worry about it, take your time. I am lucky cause I have a laptop, otherwise you'd see much less of me-I lie down all the time, sometimes I sit up but not for long.

 
Old 02-21-2005, 03:06 PM   #5
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Re: Mel, regarding failed back fusions

not to highjack a thread either, but wanted to say hi to you both!

i hope the results are positive for you next month, mel.

betty - how have you been lately?

cheers to you both!!!!
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Rampage
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Old 02-21-2005, 03:48 PM   #6
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Re: Mel, regarding failed back fusions

Hi

Just wanted to add something. I have what is termed a failed fusion. The bone is said to have gaps in it however I am able to lead a relatively pain free life. My recent probs stemmed from an l3/4 bulge above the double fusion. That has now settled and I am well on my way back to normality

Losy

 
Old 02-21-2005, 03:56 PM   #7
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Re: Mel, regarding failed back fusions

Thanks for this thread guy's, the part about the soda never even occurred to me. Since the surgery though I have started drinking more milk (never did before), and I also take calcium supplements. You have a great thread going on here. I hope you keep it going, alot of things we don't think of, you have stated here. As for the Pepsi, It never occurred to me as a problem, I was taught all my life about my one cousin, her hair is very dry and looks more like Phyllis Diller (seriously), Mom always told us it was because she would never drink milk or take any calcium, and it showed in her hair.
Stardust

 
Old 02-21-2005, 05:33 PM   #8
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Re: Mel, regarding failed back fusions

Rampage: not to change the subject, but I have been down with the flu for days and days. I worked on Thursday and Friday, which put me on my feet all day long, but it was great to be around the kids again.

Both nights I came home and went straight to sleep. Saturday through today, I have been in bed, no walking, even though it was beautiful outside. I could not stand it any longer and got up, dressed and we walked to the eye doctor, about two miles away and then to lunch, another five miles from here. So, quite a long walk. I think that I am out the other side of the flu now, just using a lot of Kleenex.

For the first time in longer than I can remember, I woke up pain free. But, my husband woke up in pain, in the same place that I have hurt for two years. He is now down for the count.

I can only hope that the state of no pain lasts longer than today. This is the first day that I have not resorted to Advil.

I am still going to look up that info for Mel, maybe tomorrow.

take care,

 
Old 02-21-2005, 08:44 PM   #9
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Re: Mel, regarding failed back fusions

I had my xray today so I will know on Thurs afternoon how things are going. Hopefully things are going well

 
Old 02-22-2005, 01:11 PM   #10
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Re: Mel, regarding failed back fusions

Mel, I am going to do some cutting and pasting but I got permission from the guy who wrote the stuff, so here goes:

[B]Autogenous Bone Graft[/B]
The gold standard of bone grafting is taking the patient's own bone. This is called autogenous bone graft. This means that at the time of surgery, the surgeon makes a separate incision and takes a small piece of bone from an area of the body where it is not needed. Typically, autogenous bone grafts are taken from the pelvis or iliac crest. Autogenous bone grafting has excellent fusion rates and has become the standard by which all other biologics are measured. Many surgeons prefer autogenous bone grafts because there is no risk of the body rejecting the graft since it came from the patient's own body.

100% fusion rates are not always achieved, which is why other fusion techniques have been developed.

[B]Allograft Bone Graft[/B]
In an effort to minimize the problems associated with taking the patient's own bone, a number of other fusion techniques have been developed that use biological products as bone graft extenders or as bone graft replacements. One common source of bone graft replacement or extender is the use of allograft bone. An allograft bone graft is bone harvested from cadavers or deceased individuals who have donated their bone for use in the treatment of living patients. COLOR=Red]This is commonly used in many forms for spinal fusions ranging from cervical interbody fusions to lumbar interbody fusions and can provide excellent structural support.[/COLOR]

The disadvantage of allograft structural bone is that it does not promote bone growth very well and therefore is very weak at stimulating a spinal fusion. Although it is used successfully for short-level fusions in the cervical spine, it is not a powerful enough biological stimulant to allow us to successfully use this to achieve a spinal fusion in the thoracic or lumbar spine. [COLOR=Red]Studies have shown that when using allograft bone as the only graft material, the fusion rates in the thoracic and lumbar spine are extremely poor and the failure rate is very high. [/COLOR]


[B]Other Graft Extenders[/B]

There are several substances such as ceramics, calcium phosphates, and other synthetic materials which have similar biomechanical properties and structure to that of cadaver bone; however, they are not biologically active and do not stimulate a spinal fusion by themselves. These products are currently only recommended for use as bone graft extenders. There has been recent interest in supercharging these materials by adding bone marrow aspirate. This is a procedure in which bone marrow cells are taken up in a syringe and soaked onto the structural carrier such as the ceramics or cadaver bone. Since by themselves these products are not biologically active, the addition of the patient's bone marrow cells can give them more biological activity. [B]This is currently being tested; however, there are no good long-term studies in humans showing this to be efficacious in stimulating spinal fusion. To date, the results have shown this technique to be inferior to using the patient's own autogenous bone graft. [/B] There are several synthetic carriers being developed which also will need stimulation with bone marrow cells to have some type of biological activity. [COLOR=Red]Unfortunately studies have shown that these carriers also fall far short of using the patient's own bone. [/COLOR]

There was a lot of other information but this is the gest of it.

I hope that your fusion is progressing and that by next year you are announcing a full fusion.

Last edited by injured betty; 02-22-2005 at 01:12 PM.

 
Old 02-22-2005, 09:32 PM   #11
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Re: Mel, regarding failed back fusions

Rampage: I have two speeds, stop and go. When I start walking, I have to have a goal, say, ice cream at a store five miles away. Then I walk. When my husband had his neck fusion in October we were told to walk, walk, walk. We got into the habit. It is strange. I hate to get up and go out the door, but once I am out there, it is so beautiful out there that I love to walk. We have had some wonderful weather here lately which is great for walking. But, even in the rain, we walked. Where we live, layering is everything.

I think that I might have finally walked my pain away. This is day two of no pain. I got out and mowed the lawn, pulled weeds, and sunbathed. Then, I came in and vacuumed. I was on a roll and I still am pain free. I have no idea why unless it is all the walking.

As for the ADR and BMP, I left those out because I was trying to address the difference between using your own bone and using a cadaver bone. There are several ways of doing this. Thanks for adding those in

Mel had the cadaver, no BMP (I think) and no cages or sponges. The ideal would have been to use the illiac crest. But, she is young and it should work for her. My husband didn't get the illiac crest either, he got the BMP mixed with his own bone marrow, cages and rods/screws.

The upside is that if you don't use the illiac crest the first time, if your fusion fails, you can always go back and use it.

I am not sure if Stardust was addressing the sugar of soda or the carbonation or the need to drink calcium. The carbonation and the sugar sucks calcuim from your bones and teeth. The caffiene is also bad for the fusion process. Sugar can throw your entire body into a yeast infection. I try to keep mine in balance. Right now I am working on cutting out chocolate.

take care,


 
Old 02-23-2005, 08:03 AM   #12
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Re: Mel, regarding failed back fusions

It was about seeing first hand what the lack of calcium can do to a person, even on the outside, per: my cousins state of health and her hair being dry and frizzed, no calcium in her diet at all. And it showed. Nothing to do with the fusions, but if a lack of calcium can do that, then that is why I now drink more milk and take calcium supplements. I asked my surgeon about this and he said doing this is an excellent way to help the fusion work better.
Stardust

 
Old 02-23-2005, 08:26 AM   #13
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Re: Mel, regarding failed back fusions

Stardust,

Thanks for clearing that up.

Calcium is a good thing!


 
Old 02-26-2005, 09:41 PM   #14
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Re: Mel, regarding failed back fusions

I am a little concerned now about my dr. I found out he didn't do a spine fellowship, and he is only board eligible, where his associate (the one I orig. wanted to see) is both. Also, I had no cages and no BMP but my dr said my xray was looking great. So, not too sure. I have pain still but a lot of it is in my neck and who knows how much of that is radiating down my back. The group of drs I chose in MO are Orthos(that doesn't matter) but they ALL did spine fellowships and specialize in both cervical and lumbar spines. So, I will def see one ASAP. My dr is going to "treat" me long distance I guess, he wants a new xray in six weeks and wants me to MAIL it to him then he'll decide if I can keep the brace off.
I fly on Tuesday and won't have internet probably for a week after, so I'll let you know how things go then. I might be able to steal my sister's comp for a few hours.

 
Old 02-27-2005, 12:02 PM   #15
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Re: Mel, regarding failed back fusions

Mel, have the x-rays showed the start of the fusion process yet? Keep us informed.


 
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