What is an implant ?

Anything that is left behind in the body after surgery is implanted (hence Implant) Typically they are things like cages and screws. Other things are bone or bone substitutes. Even electrical devices are implanted. An artificial disc is an implant.

Why are they used ?

In spinal surgery after bone has been removed and we need to hold the spine together while we allow healing to occur we use metal rods and screws, or cages and plates. These are to reduce movement till the bone we place fuses.

If you have poor bone we may use a bone substitute or a bone protien to ecourage healing.

If the disc is removed we need to support the vertebra above and this is done with cage.

Are they safe ?

Anything Implanted should have been well tested prior to use on you. Check with your surgeon that you are not part of a trial. Always ask your surgeon if they have been tested. We can not always say that in 30 yrs that there may be no problem from any implants.

Will my body reject them ?

The implants used in spinal surgery are not generally rejected. You do not need anti rejection drugs.

What are the long term consequences ?

Most patients have no long term sequele from any implants. Some times they may rub or cause local problems so need to be removed.

Will the implant wear out ?

Only implants that are involved in motion should wear, these are things like disc replacements. These are unlikely to wear out.

Will the implant fail ?

Screws can snap at the base of the screw if a fusion does not occur. rods may also snap. Cages can sink into the vertebral bodies.

Is the risk of infection higher if I get an implant ?

Yes any foreign body that is implanted increases the risk.

Do I have to have them ?

Not always, somtimes there is no alternative. ask your surgeon.

How much will they cost me ?

Most implants are rebatable to your health fund. Some they will not cover the full cost of. your surgeon should advise you of this prior to surgery.

Can I have an MRI with my implants ?

Generally it is only electrical implants in the spine that stop you having an mri.

Will my implants set off the metal detectors at the airport ?

Not usually in this day and age get aletter from your doctor before you travel. most implants are now titanium and do not affect the metal detector.

In the spine are some Implants better than others ?

Yes and No. The poor succes of some implants is because of how they are used. Some are better for specific tasks. Most implants are of good quality.

What makes a surgeon use a particular implant ?

Experience, comfort, quality, support, availability, price to the patient.

Does a surgeon get a "kickback" to use a certain type of implant ?

Some may get something from the company. Your surgeon may own the patent on the implant. Ask your surgeon.

Can I refuse to have any implants ?

Yes but it may increase the chance the operation is unsuccessful, or make it not possible.

Will the implants ever get removed ?

Not usually

What are some of the implants used in spinal surgery ?

Disc replacements made of metal and plastic

Osteogenic protein (OP1) used to promote bone growth in a fusion.

Tricalciumphosphate (TCP) a synthetic bone matrix and bone substitute

Peek substance used to make cages

Interbody cages Placed into the disc space to hold it open and support the vertebra from the front after disc removal

Pedicle screws Screws that go into the vetebral body from behind to hold two vertebra together, usually made of titanium or stainless steel and joined by rods

Interspinous distractor goes between the spinous processes at the back of the spine. Thought to reduce the degeneration in a disc.

Carbon fibre used to make cages

Bovine bone cow bone used either as granules or as block to reduce the need use your own bone

Vertebral cages replaces a vertbral body that has been removed because of cancer or trauma

Plates generally aplied to the front of the spine and is used to hold things together till a fusion occurs.