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Problems With Spine Implants: Risks and Complications

problems with spine implants

Many patients believe that because spine implants typically only require minimally invasive surgery, there are fewer risks and complications associated with these procedures. However, there are a variety of problems with spine implants, making these procedures more complicated and risky than many might believe. These issues include metallosis, wear, corrosion, migration, fracture, and many more.

Keeping Discseel® Procedure patients informed is a priority for us, so we’ll be discussing these problems in detail today. Being an informed patient is the best way to advocate for your health and ensure that you get the right treatment for your needs.

About Spinal Implants

Spinal implants are usually used for a few different reasons, such as assisting in the fusion of two vertebrae, improving spine stability, strengthening the spine, correcting spine deformities, treating degenerative spine diseases, spinal stenosis, and more. They commonly come in the form of the following:

Cages. These are medical devices that have a hollow center and perforated walls. Cages are most commonly used to treat patients that have a collapsed spinal disc. The cage is placed around a set of discs to encourage bone growth, stabilizing the spine. 

Hooks. This implant is used with other devices, usually rods, to anchor them in place. There are many different types of hooks, including sublaminar and intralaminar.

Plates. Plates are shaped to mold to your spine’s shape. They’re commonly held in place by screws.

Pedicle screws. These implants are used as anchor points for spinal rods. They are used to secure bone fractures and vary in size and shape.

Rods. This implant is a flexible device typically used to restrict the movement of certain portions of the spine. They may be rounded, smooth, or threaded.

Spinal cord stimulator. Spinal cord stimulators are implants that send electric shocks to the spine in an effort to relieve back pain. Stimulators may be used along with medical-grade cables to apply tension to the spine as well.

Artificial lumbar disc. Artificial discs are most commonly implanted from the front of the spine into the space between the vertebrae in a procedure known as arthroplasty. These discs are made from a variety of materials, such as metals, plastics, metal and plastic composites, and more. 

problems with spine implants
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Problems With Spine Implants

There are many factors that can lead to problems with spine implants, including spinal implant failure. This includes the type of spine surgery used to implant the device as well as the complexity of the surgery. Both of these factors have a significant impact on the wear and tear spine implants go through. In addition to this, the type of implant placed in the spine, as well as the degree of force applied to it, are other risk factors that can lead to problems with spine implants.

Metallosis

Patients must also be monitored regularly after undergoing spine implant surgery to detect the possible development of metallosis and implant failure. Metallosis is a condition in which a patient’s blood becomes poisoned due to high levels of toxic metals in the blood. It commonly occurs when particles of metal from implants enter the bloodstream as well as tissue around the implant.

All spine implants will go through wear and corrosion. Wear is the mechanical process that is caused by changes in load distribution and micro-motion. Corrosion is how we refer to the electrochemical process of metal deterioration. Wear and corrosion both lead to debris from the implants being released into surrounding tissues and, eventually, the bloodstream. Over time, this may require revisional surgery. Complications associated with metallosis, wear, and corrosion include unidentified pain, neurological effects, implant loosening, implant failure, swelling, and metal staining of tissue.

In addition to this, different materials have been shown to cause different reactions. Cobalt is believed to lead to cellular apoptosis and necrosis. Aluminum is linked to seizures, epilepsy, and Alzheimer’s disease. Titanium is believed to inhibit osteoclastic activity, accelerate osteoclastic differentiation, and cause osteolysis.

Studies Documenting Problems With Spine Implants

In this article, a 36-year-old female patient who underwent spine surgery to receive cobalt-chrome rods and titanium fixtures for adult scoliosis had to have these instruments removed. This was recommended because soon after they were implanted she experienced continual pain and muscle twitching. These instruments were removed two years after implantation and doctors found that the tissue around the implant had metal staining.

There have been many cases published in which revisional surgery for implants could be strongly linked to corrosion and wear of the implants. 

A study published in 2017 reported on the development of metallosis in a patient who received a cervical disc replacement known as a Bryan Disc implant. Eight years after the implantation she sustained a whiplash injury that caused the disc to loosen, leading to metallosis. Once this was found, the implant was removed immediately to treat this condition.

A 2016 study focused on a patient who experienced metallosis following the implantation of titanium instrumentation. This metallosis led directly to neural tissue compression.

problems with spine implants
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Other Issues with Spine Implant Surgery

In addition to metallosis, wear, corrosion, and the issues highlighted in the studies discussed here, problems with spine implants also include typical risks linked to spine surgery

Anesthesia complications. The majority of spinal operations require general anesthesia, which is known to cause issues for some patients. These issues include reactions to the drugs used for anesthesia and problems exacerbated by a patient’s existing medical issues. 

Infection. All surgeries carry a risk of infection. An infection may only affect the area of the skin where the incision was made, known as a superficial infection. However, the infection may go deeper and affect areas around the spinal cord and vertebrae. These infections are much more serious and may require additional operations to treat the infection. It may even require the removal of spine implants. 

Hardware fracture. When instruments such as screws, plates, or rods are implanted into the spine, they may break or move. This is known as a “hardware fracture” and may require additional surgery to remove or replace the hardware.

Implant migration. This term refers to implants that have moved from where they were placed during surgery. Migration typically takes place soon after implantation, before healing is complete and the implant is firmly held in place by scar tissue or bone growth. An implant that moves too far can have serious consequences, such as failing to stabilize the spine or damaging the spine. This is an issue that may also require additional surgery to replace the implant.

Spinal cord injury. All spine surgeries risk injuring the spinal cord. This can seriously injure nerves or the dura, leading to consequences such as paralysis of certain areas of the body.

Persistent pain. Sometimes, spine surgery simply fails. It’s very common for surgery to fail to completely relieve a patient’s pain. In fact, surgery may actually worsen pain in some cases.

Sexual dysfunction. The spinal cord is a very sensitive area and the spinal nerves carry signals that allow the body to function, feel, and have sex. Spinal cord damage can affect the pelvic region, leading to sexual dysfunction.

Transitional syndrome. In a healthy spine, each segment works to share the load and stress placed on the spine. Unfortunately, when one or two segments aren’t working, such as when they’ve been immobilized by fusion or other surgery, the adjacent segments take on greater stress. Over time, these segments of the spine can wear down, leading to degeneration of the spinal discs in these areas. Dr. Pauza refers to this as “the domino effect”.

Pseudoarthrosis.  This term refers to a fractured bone that has not healed or a fusion that was not successful. Pseudoarthrosis usually indicates that there’s motion between two bones that should be fused together. This typically leads to continued pain, which may increase over time. The motion caused by this may also increase stress on the instruments implanted as part of the fusion, causing screws or rods to break. This often requires revisional surgery to replace metal hardware, add more bone graft, or add a stimulator.

The Discseel® Procedure – A Better Way

As you can see, there are a variety of problems with spine implants and risks associated with spine surgery. In addition to this, annular tears are one of the most common causes of back and neck pain caused by spinal disc issues. No surgery can relieve the pain caused by annular tears. What does this mean? This means that taking on the risks associated with spine surgery will not relieve your pain. Fortunately, there’s a procedure that can address annular tears, providing lasting pain relief. 

The Discseel® Procedure is a non-surgical, minimally invasive procedure that has provided back and neck pain relief to many patients.

How does it work? The Discseel® Procedure takes Fibrin, an FDA-approved biologic that is used off-brand in this procedure, and applies it to tear spinal discs. This then seals and heals annular tears the same way your body would seal and heal a cut on your hand or anywhere else on your body. Fibrin also encourages your torn spinal discs to grow new tissue for lasting healing, something they can’t accomplish on their own.

If you’re ready to stop living with back or neck pain, apply for the Discseel® Procedure today and find out if you’re a candidate!


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Kevin Pauza, M.D.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Travis Foxx, M.D. - Premier Anesthesiology & Pain

Kevin Pauza, M.D. - Turtle Creek Surgery Center

Prior to attending Penn State University, Dr. Pauza earned his undergraduate degree from Lehigh University, and furthered his training with a Surgical and Medical Internship at Columbia University College of Physicians and Surgeons. He continued his specialty training at the University of Pennsylvania, followed by an Interventional Spine Fellowship. In addition to his research, philanthropic, and clinical endeavors, Dr. Pauza remains a motivated educator. He established a Spine Fellowship program and continues training physicians from around the world. He heads international committees responsible for establishing standards and educating surgical and non-surgical physicians.

After helping hundreds of patients who failed to experience relief after spine surgery, it became evident to Dr. Pauza that current methods needed to change. This motivated him to seek better ways to help patients, by thinking outside the box.

Dr. Pauza is the first physician in history to pursue FDA approval for using biologics to treat the spine. Millions of patients will benefit from his development of minimally invasive treatments for degenerative disc disease and other more common and serious disorders of the spine.

SPECIALTY

  • Disc Biologics
  • Interventional Spine

EDUCATION & DEGREES

  • Fellowship: Interventional Spine, University of Pennsylvania
  • Residency: PM&R, University of Pennsylvania
  • Internship: Surgery & Medicine, Columbia University College of Physicians and Surgeons
  • Medical Doctorate: Pennsylvania State University College of Medicine
  • Bachelor of Arts: Biology, Lehigh University
  • Bachelor of Arts: Psychology, Lehigh University

CERTIFICATIONS & LICENSES

  • Texas State Medical and Surgical License
  • New York State Medical and Surgical License
  • Florida State Medical and Surgical License

HONORS

  • Lehigh University Four-year Academic Scholarship
  • Magna Cum Laude, Lehigh University
  • Lehigh University President’s Award
  • Lehigh University Tower Society
  • Distinguished Alumnus, Penn State University (selected from 500,000 Penn State alumni)
  • North American Spine Society, Outstanding Paper of the Year, 2003
  • President-Elect, International Spine Intervention Society
  • Founding Partner, Texas Spine and Joint Hospital
  • Commencement Speaker: Penn State University College of Medicine
  • Advisory Board, AMA
    Keynote Speaker, Harvard Pain Center Commencement
  • Founding Chairman, Standards Committee, International Spine Intervention Society
  • Chairman, Spine Committee, Amercian Academy of Physical Medicine & Rehabilitation
  • Appointed Spine Advisor, Japanese Prime Minister
  • Appointed Spine Advisor, Allied Royal Families

EXPERIENCE

  • Founding Partner & Principal, Texas Spine & Joint Hospital

Brandon Tolman, D.O. - Nashville Spine Institute

Boris Terebuh, M.D. - Regenerative Spine & Joint Center

Boris Terebuh, MD specializes in providing personalized nonsurgical solutions for spine problems that interfere with the function patients desire and the independence they deserve. Dr. Terebuh completed his Physical Medicine & Rehabilitation residency training at The Ohio State University in 1997 and has been in solo practice in Ohio since 2001 because he is committed to providing accessible, individualized and attentive care to his patients. His regenerative approach to solving spine problems enhances the body’s natural ability to heal itself. His guiding principle is integrity – doing what is right for patients in a conscientious manner with the motivation of helping them become fully functional, independent and satisfied. Dr. Terebuh is a very unique Medical Doctor because he has earned seven Board Certifications in the field of musculoskeletal medicine and nonsurgical spine care. Boris Terebuh, MD is delighted to be a Discseel® provider because this revolutionary new technology aligns perfectly with his preferred regenerative treatment approach and patient care philosophy. Dr. Terebuh is also grateful to Discseel® developer, Kevin Pauza, MD, for all the years of diligent and meticulous research to create this innovative, paradigm-shifting intervention, which will certainly spare countless individuals the prospect of avoidable spine surgical procedures.

Thierry Bonnabesse, M.D. - Champlain Spine and Pain Management

Gregory Lutz, M.D. - Regenerative Sportscare Institute

Dr. Gregory Lutz is the Founder and Medical Director of the Regenerative SportsCare Institute (RSI). In addition, he currently serves as Physiatrist-In-Chief Emeritus at Hospital for Special Surgery (HSS) and a Professor of Clinical Rehabilitation Medicine at Weill Medical College of Cornell University. Dr. Lutz is one of the world’s leading experts in the field of regenerative interventional orthopedic medicine, appearing annually on Castle Connolly’s and New York Magazine’s “Top Doctors” lists.

Janet Pearl, M.D. - The Boston Stem Cell Center

Dr. Janet Pearl has been in practice since 1999 and is the Medical Director of The Boston Stem Cell Center. She is also the Medical Director of  Complete Spine and Pain Care  an interventional integrated Pain Management practice, both located in Framingham, Massachusetts. Dr. Pearl is Triple Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology and has over 20 years experience in doing these procedures.

Previously, Dr. Pearl was the Co-Director of the Pain Management Center at St. Elizabeth’s Medical Center, where she was also the Director of the Pain Management Fellowship program.

After graduating from Harvard College with an A.B. in Applied Mathematics with Economics, Dr. Pearl received a M.Sc. in Health Planning and Financing at the London School of Hygiene and Tropical Medicine. She then received her M.D. from the Columbia College of Physicians and Surgeons, where she represented the Medical School as a senator in the Columbia University Senate.

Watch Dr Pearl give an introduction to The Boston Stem Cell Center

Dr. Pearl completed her internship in Internal Medicine at New England Deaconess Hospital, her residency in Anesthesiology at the Massachusetts General Hospital, and her fellowship in Pain Management at the Brigham and Women’s Hospital. Dr. Pearl was the first resident ever to serve on the Accreditation Council for Graduate Medical Education (ACGME)’s Residency Review Committee for Anesthesiology. She is a Joseph Collins Scholar and a Rotary Scholar and was awarded the AMA/Glaxo Welcome and AMA/Burroughs Welcome Resident Leadership Awards.

From 2004 to 2010, Dr. Pearl served on the University of Massachusetts Board of Trustees. While there she chaired the Committee on Science, Technology and Research, was a member of the Committee on Academic and Student Affairs and the Governance Committee and also served as Vice Chair of the Advancement Committee, and as a member of the Committee on Athletics.

Dr. Pearl is Board Certified in Regenerative Medicine, Pain Medicine and Anesthesiology with the American Board of Regenerative Medicine and the American Board of Anesthesiologists.

Memberships:

  • The American Pain Society;
  • The Massachusetts Medical Society;
  • The Massachusetts Society of Anesthesiologists;
  • The Massachusetts Society of Interventional Pain Physicians;
  • The American Society of Anesthesiologists;
  • The American Society of International Pain Physicians;
  • The American Institute of Ultrasound in Medicine; and,
  • The American Board of Regenerative Medicine.

PUBLIC SERVICE:

  • Member, Massachusetts Department of Industrial Accidents, Health Care Services Board 
  • Member of the Association of Harvard College Class Secretaries and Treasurers
  • Past Member of the Board of Directors of the Harvard Alumni Association
  • Former Member of the Board of Trustees University of Massachusetts. (10/2010 – 10/2014) 

Mark Reecer, M.D. - Fort Wayne Physical Medicine

Dr. Mark Reecer is board certified in Physical Medicine & Rehabilitation and Pain Management. He has over 20 years of work comp experience, and he routinely provides Independent Medical Examinations (IMEs) for the Indiana Workers’ Compensation Board. Dr. Reecer has lectured extensively and has authored multiple publications that promote his specialty and the use of treatment modalities to eliminate pain, improve function and avoid surgery.

Dmitry Buyanov, M.D. - IV Infusion Treatment Center

Dr. Buyanov is originally from Kiev, Ukraine. He received his training in Anesthesiology and his Interventional Pain Management Post-Doctoral at Penn State Medical Center, PA. Dr. Buyanov moved to San Antonio in 2003 at which time he was part of a multi-specialty group before he founded Premier Pain Consultants in 2004. His practice has over 5000 active patients in his practice. Dr. Buyanov treats his patients in a cost-effective manner although giving them the best care with interventional pain treatments/procedure to help each patient improve their quality of life. Dr. Buyanov strongly believes in an individualized and multidisciplinary approach to pain management, he believes in the Buddhist saying: “pain is inevitable but suffering is optional”. He works closely with the area internists, physical therapists, chiropractors, psychiatrists, neurologists, and spine surgeons to insure that each patient has the most optimal individualized treatment plan. Dr. Buyanov enjoys spending his spare time with his children.

Desmond Hussey, M.D. - NASA Neuroscience and Spine Associates. P.L

Dr. Hussey earned his undergraduate degree from Dartmouth College, and proceeded to earn his Medical Degree from The University of Miami School of Medicine. He then attended Northwestern University Internal Medicine Program, followed by a Neurology Residency Program at Emory University. Dr. Hussey continued his specialty training at John Hopkins University pain clinic. A member of The Spinal Injection Society and The American Academy of Neurology and Psychiatry.

Haley Burke, M.D. - Mile High Sports and Rehab

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Maxim Moradian, M.D. - Interventional Spine Care & Orthopedic Regenerative Experts

Dr. Moradian is triple-board certified in Physical Medicine and Rehabilitation (PM&R), Sports Medicine and Pain Management. Dr. Moradian’s clinical practice is devoted to the comprehensive care of spine, joint, muscle, tendon, ligament, and peripheral nerve disorders. He is proficient in performing advanced, minimally-invasive procedures under fluoroscopic and/or ultrasound guidance in the entire spine. Dr. Moradian performs electrodiagnostic testing (EMG/NCS) for the accurate diagnosis of muscle and/or nerve disorders. He has a special interest in regenerative medicine, sports concussions, neuromuscular ultrasound, medical education, and clinical research. His true passion is to treat his patients like his family and friends.

Wendi Lundquist, D.O. - Active Life Physical Medicine & Pain Center

Dr. Lundquist is the Medical Director and founder of Active Life Physical Medicine & Pain Center, Innovative Surgery Center, and Regena Spa. She is dual board certified in Physical Medicine and Rehabilitation along with Pain Management and a diplomat with the American Board of Pain Medicine. She completed her training at Loyola University in Chicago, Illinois in July of 2005. During her time there, she served as Chief Resident and was involved in several research projects. Prior to, she completed medical school at Midwestern University at the Arizona College of Osteopathic Medicine campus in Glendale, Arizona and internship at Doctors Hospital in Massillon, Ohio. She also has a Bachelor of Science in Biology and minor in Chemistry from the University of New Mexico in Albuquerque. She has a special interest in sports medicine, pain and spine. With 17 years experience, she has great enthusiasm towards regenerative medicine.

Yasuyuki Nonaka, M.D. - ILC International Lumbago Clinic

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Haley Burke, M.D. - Colorado Rehabilitation & Occupational Medicine

Dr. Burke is board-certified in both Interventional Pain Management and Neurology and has completed an accredited Pain Fellowship with the Department of Anesthesiology at MD Anderson Cancer Center, one of the nation’s most prestigious hospitals. Dr. Burke completed her residency in Neurology at the University of Colorado, where she received the department’s ‘Excellence in Teaching’ award during her year as Chief Resident. Her Doctor of Medicine degree was completed at the University of Texas Health Science Center, where she was elected to the ‘Gold Humanism Honor Society.’

Matthias H. Wiederholz, M.D. - Performance Pain and Sports Medicine

Founding Partner, Triple Board Certified – Physical Medicine & Rehabilitation; Sports Medicine; Anti-Aging, Regenerative & Functional Medicine

Dr. Matthias H. Wiederholz is cofounder of Performance Spine & Sports Medicine, LLC. He is a fellowship-trained interventional pain physician whose clinical interests include: Interventional Pain Management, Sports Medicine, Musculoskeletal Medicine, Minimally-Invasive Spine Surgery, Non-Surgical Orthopedics, and Anti-Aging / Functional Medicine.

He received his specialty training in Physical Medicine and Rehabilitation at Baylor College of Medicine in Houston, Texas where he served as chief resident. He completed fellowship training in Interventional Pain Management in Marietta, Georgia. He is board-certified in Physical Medicine & Rehabilitation and Sports Medicine. He also received advanced fellowship training through the American Academy of Anti-Aging Medicine and is board-certified in Anti-Aging, Regenerative & Functional Medicine.

Dr. Wiederholz performs a myriad of interventional pain procedures including, but not limited to the following: epidural steroid injections, facet joint injections, radiofrequency ablation, sacroiliac joint injections, discography, percutaneous disc decompression, epidural lysis of adhesions spinal cord stimulator implants, and minimally-invasive discectomies. Endoscopic spine surgery is a very unique and valuable tool in his armamentarium and makes Dr. Wiederholz one of the most specialized physicians in the field of Pain Medicine.

Dr. Wiederholz uses musculoskeletal ultrasound in the diagnosis of musculoskeletal injuries. He incorporates ultrasound for precise injection therapy including cortisone injections, prolotherapy, and PRP (platelet rich plasma). This technology is also utilized to perform the Tenex procedure, a percutaneous procedure for treating chronic tendon pain (tennis elbow, rotator cuff, plantar fasciitis, etc).

Dr. Wiederholz is the fellowship director for the sports and spine fellowship at Performance Spine & Sports Medicine. Dr. Wiederholz holds an affiliation with Capital Health System and JFK Johnson Rehabilitation Institute.

Being advanced fellowship trained in Anti-Aging, Regenerative & Functional Medicine means that Dr. Wiederholz has the most advanced training in Anti-Aging Medicine available. He is a leading expert in Bio-Identical Hormone Restoration and helps patients achieve wellness through nutrition, lifestyle, and hormone therapies.

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Michael Wolff, M.D. - Southwest Spine & Sports