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Instrumentation |
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- Do I need to wear a brace after surgery?
The wearing of a brace is a personal decision made by the surgeon. Factors contributing to collar usage include, number of levels fused, vertebrectomy verses discetomy, age of the patient, quality of the patients bone. Other factors include the patients physical health ie: diabetes, smoking, obesity. I believe the titanium plate eliminates the need for the brace in most cases.
- Does it matter what screws and rods my surgeon uses?
Structural and functional differences exist between the different spinal instrumentation products available. Your spinal surgeon should weigh these differences to determine the best product for your specific problem.
- What’s the current status of artificial disk replacement?
The clinical trials for the SB III Charite disc replacement (artificial disc) study are currently underway at ten sites in the United States. The procedure is an experimental type of surgery in the US. The FDA is allowing a small number of selected doctors to use the SB Charite on a specific number of patients.
The surgical procedure for the SB Charite places an implant using the anterior (front) approach. The disc is removed at the effected level and the SB Charite device is placed into the space. Much like an artificial hip or knee system that relies on metal and plastic to replicate normal movement, the SB Charite is designed to mimic the function of a healthy disc.
- What’s spinal cages and why they are used?
Spinal cages can mean either struts or threaded dowels. The purpose of either type is to reconstruct the anterior spinal column. The struts such as the Harms cage are usually supplemented with posterior instrumentation such as pedicle screws. The threaded dowels provide a stiffer construct initially and may not require supplemental hardware. We use cages, ramps, interbody dowels and intervertebral bone graft frequently.
The cage is an alternative for other means of supporting the anterior column such as the patient's own bone, typically a tricortical ilium or a portion of the fibula. In some cases, allograft, bone from another donor, is used.
- How are spinal cord stimulators implanted?
Dorsal column stimulators, also called spinal cord stimulators, are useful to treat otherwise intractable pain syndromes.
With the patient awake, the electrodes are placed on the dura - the covering of the spinal cord. Current is passed through the electrodes. With careful positioning of the electrodes using feedback from the patient, the pain signals can be disrupted. The patient reports a buzzing sensation over the portion of the body innervated by the spinal cord track being stimulated. If the surgical trial obtains pain relief, a battery and electronic pack is implanted subcutaneously usually over the abdomen and wired to the electrodes. The device may produce an improved quality of life for months or years.
Potential problems include infection, neurologic injury, disruption of the device by external magnetic fields, the need for battery change, or electrode repositioning.
- What is INFUSE Bone Graft and how does it compare to the natural protein in my body that helps bones to grow?
INFUSE? Bone Graft contains a commercially available protein that has been purified to specifically generate bone in the immediate area that it is placed. The actual history is that 30 years ago scientists discovered that certain proteins were present in fracture/ bone healing. Scientists purified those proteins and found a number of bone morphogenetic proteins, meaning proteins that will change cells into bone producing cells. Once they identified a number of proteins, they identified the ones that worked best. Many researchers spent years and years purifying these to the point where they could reliably produce bones in humans. Then they used the current technology to take the protein and manufacture that in a commercial sense so that you have the product available today that we know as INFUSE Bone Graft.
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