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Back Problems Message Board

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I've had multiple fusions so will give you a brief fusion history. One prior to BMP, when bone was taken from the hip crest and it took more than a year to heal. The hip was worse than the back as far as the healing and the pain.

My first 3 level fusion was a couple of days after the FDA approved it's use but as my spine specialist was already on board, he was aware of problems encountered during clinical trials, so took precautions to avoid the problems seen with BMP getting into unwanted areas. It worked beautifully! Later, I was in a MVA and the first fusion broke, so I had the 3rd three level fusion when the first one had to be redone. Then, more levels collapsed so just 9 months ago I had a 10 level fusion from T10 through S3.

As to having fusion without anything such as the cages being placed between the disc, it isn't something I would even consider. The reasons are that our disc provide spacing between our vertebrae and if these are removed and nothing is put in to space the vertebrae, we loose even more height than we do with the current process of our disc degenerating and with fusion with cage. BTW, with my massive fusions I've lost 3 1/2 to 4 inches in height, and I was short anyway, but I wonder when it becomes so much that the doc can no longer pack the spinal cord into less space! Sure we can buy more clothes to adjust, but I'd like to have been able to keep what little height I had.

Secondly, because early on there were a number of off-label procedures where cages were not used, and the BMP got into unwanted areas, thereby encasing some nerves and creating worse problems for some patients. The manufacturers and FDA came to terms and now the BMP is packaged so that in order to buy the BMP doctors (at least in the US) have to purchase the cages. Granted that does not force the doctor use the cages, and yes there are still off-label procedures done, but that is something that the patient and doctor must decide whether it is right for their condition and the patient is willing to take the risks, IF those risks are explained to them.

Not sure what you mean by natural fusion just because the BMP is placed in cages. I can tell you that even with 10 levels being fused,things looked really good at 5 months and at 7 months I had been fused long enough to go back on my arthritis meds.

All I can tell you about the graft/donor materials is that while BMP fusions are near 100%, those which fail are most often from donor or allograft materials. After all, with that we are introducing yet another foreign material into our bodies. My doc used the ground bone from my laminectomies which spine specialist typically does with a fusion, so no need to take bone from my hip. That's been sufficient bone, and I've not had a failure or rejection yet.

There are different cages, and again I cannot tell you about the cervical area, but some other members may be able to answer you. I have three different style/types of cages, two different types in the lumbar area as the first one with BMP was done anteriorly,and the cage is way different when placed from the front, than the ones placed from the back.

Some of your thoughts may be addressed if you go to the clinical trial and FDA web sites and look at some of the reports of what was learned in the more than 5 years of trials. Those are sites I went to, to read information so that I was able to talk with my spine specialist about using this even before FDA approved it in 2002.

What I can tell you is that BMP made my recoveries MUCH shorter than the first fusion prior to BMP, and that BMP with ground bone is a much stronger fusion than your bone alone, like mine that was broken in the wreck. As my spine specialist compared it to the chipped board that is produced to make the super strong beams used in construction. Those with the superglue type material and chipped wood is then several times stronger than using a piece of solid wood - the same material. The BMP works like the super glue type material in that beam, and it too makes our fusion of bone stronger than the fusion I had which was just bone and bone.

What I do recommend to many is the web site that Bionic Witch has at the top of the threads - one on new info for lots of you. That web site has great information on ADR's, fusion with BMP as well as the Dynesys flexible fusion system. I also recommend that people use a true spine specialist instead of a general ortho or general neuro surgeons, as fixed fusion is likely all that they will offer. A true spine specialist may provide the ADR or Dynesys flexible fusion as alternatives, but the general orthor or neuro surgeons aren't likely to do so for some years. I had hopes of ADR/fusion combination which is now approved and if not, perhaps the Dynesys system, so as to retain some flexibility. Unfortunately, my spine is a disaster area, but as I have already dealt with being paralyzed once, I am so happy that even though I cannot bend anymore, I am walking and I am an active retiree.

Best wishes and hope all goes well with whatever route you take.

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