Cadaver Bone

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Has anyone had experiences or heard stories about the use of cadaver bone for spinal implants? I'll be having an ACDF soon, but due to my metal allergies I either have a choice of cadaver bone which will increase the hard collar recovery to 3 months if the neurosurgeon can't find tantalum (which I still have to get tested for, but no tests in my local hospitals can test for tantalum allergy). I heard a lot about cadaver bone not fusing and rates of transmission of diseases where some people developed head and neck cancer etc. Is it really safe?

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  • Posted

    Used for bone grafting as hip surgery over 18 years ago a cadaver bone was ground and used to fill in a hole in my pelvis .

    The doctor explained to me that the two most common types of bone grafts are: An allograft uses bone from a deceased donor or a cadaver that has been cleaned and stored in a tissue bank. An autograft comes from a bone inside your body, such as your ribs, hips, pelvis. In my case it was used in the pelvis area. 

     

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    • Posted

      In my case I had a worn out area in my pelvis bone about the size of a golf ball. A cadaver bone was used to graft in place then the ball joint was screwed in to the area around the graft. Our own bone grows over time and hold the graft in place. The same process when a implant is placed in the ball joint and the femur. Our bone is feed by our blood that rebuilds bone to hold the implants in place and secure them for many years . The graft has held for 18 years. Now all I need is to have the poly cup replaced soon. 

      Are you going to need a graft?

       

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    • Posted

      I'll probably be needing a graft for my fusion, since they couldn't find nickel free titanium hardware for my surgery. They argue that the amount of nickel is so small around 0.0004% or so that there was no evidence of it causing an allergic reaction to someone even with nickel allergy, unless of course they're allergic to titanium itself which in case I'm not. I just didn't want to risk it that amount of nickel even in me since i have severe reactions even from dermatitis. 

      So my options were allograft or autograft, surgeon recommended an allograft since an autograft would be painful, however with the non-fusion rates of a donor bone and risks of disease transmission hes looking into a new bio-inert material of tantalum which I need to be tested for. I'll be having no hardware though even with the tantalum it'll only be used as a spacer; however, it's a 6 weeks period of neck brace versus the 3 months of neck brace with the allograft.

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    • Posted

      My THR doc showed me many hip replacement components in the US made from manufactures around the world. 

      Titanium 

      Titanium is as strong as steel, but as light as aluminum. It does not corrode, does not tarnish, and in its pure state, is totally non-allergenic. It does not react to sunlight, salt-water, or any body chemistry. It can be anodized to be a rainbow of colors. 

      He also explained  that alloy metals included I. Titanium has no nickel . I have metal allergies too and never had issues from the first THR. My surgeon explained that medical titanium has four grade.

      Grades 1-4 of Titanium are pure titanium. Lower grades (higher numbers) are alloys with other metals. Grade 5 Titanium is called “surgical grade,” and although nickel free, is still an alloy used in implants today. 

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    • Posted

      My orthopedic surgeon was also mentioning that as well and that he doesn't have evidence or has read scientific studies that show people having an allergic reaction from the hardware especially if it's not the main metal itself in this case titanium, so the chances seem pretty low having a reaction toward that nickel since I'm not allergic to titanium.

      Surgical titanium is Ti6AL4V, 6% aluminum and 4% vanadium. This is grade 5 and grade 23 titanium. It may contain trace elements of nickel from processing. But to show the nickel content in other titanium grades, grade 12 and 25 has .8% nickel, less than 1%. Grade 13, 14, & 15 has .5% nickel, which is a 1/2%. Trace elements of an alloy are measured as small as parts per million.

      I've read about people suffering from their allergic experiences with titanium mixed with nickel and them having to have it removed on other spine discussion forums and such. Definitely not something I would want to risk, so we are looking into tantalum which is 100% nickel free.

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  • Posted

    I too have metal allergies.  Nickel is a common one and I definitely am allergic to that.  I'm going to assume you mean to be spelling titanium rather than tantalum.  I can answer your questions regarding allograft (cadaver bone) vs autograft (your own bone).  I've had both during two separate anterior cervical spine surgeries.  The first time, I insisted on using my own bone which was shaved from my right hip and placed into the disk space at C6-7.  That was approx. 10 years ago.  I was afraid of disease from the cadaver bone and afraid that my body would reject a donor bone as well.  My own bone fused beautifully with no hardware necessary. I was in my mid forties.  4 1/2 months after that surgery I blew out two more disks at work.  Work comp - nasty people to deal with!  Took over a year to finally get them to understand that I wasn't faking an injury for financial gain.  If you've ever had a test called a "diskogram" you'll swear it was invented to torture people!  But it proved conclusively that I needed another surgery.  I chose to use the cadaver (donor) bone for that surgery (corpectomy) because the hip area where they took my own bone the first time was extremely painful even though my neck hardly hurt at all by comparison.  

    Donor bone:  it's been about 8 years with the donor bone and I haven't gotten any diseases from it.  I have 4 screws and a plate holding C4-5; C5-6 together.  The donor bone never completely fused but it doesn't matter because the hardware is keeping everything in place.  My original autograft of C6-7 is still holding strong and it fused completely.  

    Titanium was used for the hardware.  The only problem is that it sends artifact all over the place if you need another MRI or CT scan.  It's harder for the radiologist to read your "film" if that's what they still call it!  

    I'm about to enter the world of updated technology once again.  I was involved in a rear-end collision last week (hit and run) and I had a CT done on my neck.  Disk bulge at C-3 and an osteophyte at C-3.  I also have vertigo and my short term memory is POOF - gone in an instant.  I'm hoping I won't be needing another surgery and that the vertigo and memory loss is temporary!

    Good note to add:  I had a witness to the crash who followed the woman that hit me  and watched her try to hide her car in a garage.  My witness got the license plate number and the vehicle is insured!  There are a few good folks out there that go above and beyond to help their fellow humans.  My witness returned and waited with me for the police to show up.  She has done more detective work than the Chicago police who say they "don't have the resources" to handle hit and run accidents unless there's a fatality involved.  The woman is 24 years old, has a felony record of attacking a police officer when she was 20 years old and "very intoxicated" according to the news report that my witness found after she found out the names of the occupants that live in the house where the woman hid the car in the garage.  She also found out that this woman drives her neighbor's van to pick up their children from school!!!  All that from doing a few Google searches and hitting up FB!  

    Hope my experiences with allografting, autografting and titanium are helpful.  Best of luck to you.

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    • Posted

      Wow what a heartbreaking and interesting story. So sorry you were injured so badly. Something that you will have to live with the rest of your life.

      has the driver of the other car been prosecuted for the accident. She probably hid the car because if the police did a alcohol test she would have failed. 

       

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    • Posted

      I was thinking the same thing.  The other reason is that she may not have a valid driver's license!  

      I only found out her name today.  My insurance company (Geico) had to do the investigative work to see if the other vehicle was insured.  Thankfully it is and coincidentally it is also insured with Geico!  

      I am going to see to it that the woman who hit my car is prosecuted.  She's going to kill someone if she doesn't get some kind of treatment.  My thoughts are that she may have a substance abuse issue and a mental disorder.  My wonderful witness found the name of the father of the children that she is transporting (she's a Google whiz!) and contacted him via FaceBook to let him know about her felony conviction.  I also contacted him to let him know about the hit and run.  Luckily the report about her attacking a police officer (and jumping on a moving ambulance to get at him!) has a photo of her mug shot.  It's definitely her so I'm not worried about possibly tainting her reputation.  I'm a fighter and I won't allow this woman to continue to drive or transport someone's children.  I've started a process through Chicago's "hit and run division" and once again, I talked on the phone with an absolutely amazing woman who shared her own phone number with me so I can have continuity with this case without having to repeat the entire story to a different facilitator each time I call about the case.  

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    • Posted

      What a story indeed, thanks for sharing. May I ask why you ended up needing another surgery? And tantalum is correct, although I'm not allergic to titanium there's a small amount of nickel in it which I didn't want to risk so my options are a bone graft or using the tantalum spacers for my surgery. Am scheduled for a one level fusion, but with it being postponed I'll be having another MRI done near the surgery date to decide whether it'll be a one or two level fusion. WIth the allograft I'll be looking into 3 months of neck brace vs the tantalum being about 6 weeks since they wouldn't be using any hardware whatsoever, unless of course we proceed with the titanium hardware and risk the possibilities of that small amount of nickel causing a reaction or not. 

      The bad news i heard was for a posterior surgery (if I had to have a 2nd operation after my ACDF, the only available options at that time would be using the titanium regardless of how much nickel is in it) so hopefully this tantalum business goes through, since I heard the chances of non-fusion rates of grafts such as for an allograft were higher especially without hardware for my anterior fusion.

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    • Posted

      Hopefully your insurance company has the responsibility to do the investigation regarding the accident. 

      If if this person has a addiction problem ask the people who's kids she drives if possible. I agree that anyone with the behaviors that you described has all the red flags for addiction. 

      I would like like to add that I was hit by a drunk driver years ago the accident killed my husband and I was in a coma for 3 months. It was not easy to recover and has had physicial and emotional consequences all my life.

      Stay strong and positive, the truth always comes out.👍

       

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    • Posted

      Titanium biochemically made is a almagamation of the metals below. 

      Because titanium is biocompatible (non-toxic and not rejected by the body), it has many medical uses, including surgical implements and implants, such as hip balls and sockets (joint replacement) and dental implants that can stay in place for up to 20 years.[37] The titanium is often alloyed with about 4% aluminium or 6% Al and 4% vanadium

      however in rare cases where hip implants are metal on metal made and metal components are made from different alloys can cause cobalt toxicity showed up in my blood tests.

       

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    • Posted

      Thanks for the information, cobalt was the important one thaI forgot to mention I was allergic too as well, the titanium was also mixed with a bit of nickel so I was warned that it might cause toxicity as you mentioned when used as hardware for surgery.
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    • Posted

      I am so sorry for your loss of your husband and having to endure such horrendous hardships from someone else's stupidity.  I'll assume you also suffer from depression, anxiety and PTSD.  Got all of those myself, but from trying to force an abusive marriage to work for 32 years. 

      I had a good day yesterday with minimal vertigo and tolerable pain.  Today, however, I've caught myself from falling over by grabbing a nearby wall and leaning back on it until the vertigo quits.  A friend of mine is a MD so I asked her what she thinks is causing the intermittent vertigo.  She gave it to me staight as I knew she would.  Intermittent spinal cord compression is her medical opinion.  I know what that means.  I've been dreading the day I get hit in a rear end collision as I know there are only two disks remaining to take the impact.  This surgery will be posterior for sure.  I'm not sure if I'll be left with just C2 disk unprotected by hardware.  I was just lucky that I was able to have my second anterior spine surgery done anteriorly.  

      I'm glad I found this website so I can now educate myself on things I've never heard of, like "tantalum".  My neurosurgeon put in the titanium and he had told me that there was zero possibility of my body rejecting it.  He had a great reputation at that time.  It took about 4 years before the hospitals he was working for figured out that he wasn't having the greatest outcomes.  But he was always so nice to his patients, kind and understanding.  Being a former pre-op and recovery RN, I know that if the surgeon is known as being a difficult assH*#@ then that's the guy you want!  They can be jerks and make a great living because they are meticulous in the operating room and their surgical outcomes are almost always better than the "Oh isn't Dr. So and So just the most wonderful person?"

      So, my mission in this huge city of Chicago is to find an assH*#@ neurosurgeon, look up his pts. surgical outcomes (and never look for "self-reported" outcomes).  If the surgeon is "self-reporting" ZERO infections - RUN because they're lying (I've witnessed a lot of things as an RN).  I also have learned to write on my permit: "Absolutely NO students of any kind or Resident physicians are allowed in the O.R." on my permit. 

      Live and learn!  

      I hope you're right about the truth always coming out!  I have many reasons to hope for that to be true!  

      Staying strong and positive - and I'll think of your circumstances if I start to feel like giving up.  

      Thank you! 

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