[Donald Corenman, MD, DC]

#8264

This is a cautionary tale that inadvertent slips and falls can cause displacement of the IFuse device. This device is not held in by a screw mechanism like a lumbar fusion is so the strength of the implant is not as high as the lower back fusion. You must be careful for the first six weeks and caution needs to continue abet at a lesser degree for the next six weeks.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[SpinelessWench]

#8270

Dr. Corenman,

Yeah, cautionary is right. When I landed, I heard the pops. I briefly thought it could be internal stitches, but the pain was far too acute and severe for that. I told my friends that when it happened, I couldn’t think of an expletive adequate enough to scream out (which is unusual for my prior military and law enforcement mouth), so I just stood still for about a minute, hyperventilating and grunting like some scary character from the Hobbit.

I wonder if this is something iFuse might benefit from hearing about. And, I’m picturing in my head those wall screw anchors, the white plastic things with barbs on them, that hold screws in the wall when you’re hanging a picture. Although the iFuse implants aren’t screws, I’m thinking the device could be revised to include some kind of 3-sided “anchor jacket” (very thin) that would be emplaced first, then the actual implant inserted within and held securely in the port.

This is a rough idea, obviously. But, what about also considering some kind of small pins implanted down the side of the drilled port, then redesigning the implant to contain small divots or holes to which the pins would “catch” upon implantation?

As a current patient having just undergone 2 of these rather new procedures, I can promise you that it HURTS when those implants are displaced. And, mine was shoved directly into the S-2 nerve outlet, completely trapping the nerve exiting the hole. I told my surgeon that with all the ruptured disks I’ve had throughout my life, and with all of the foraminal obliterations I’ve experienced, the nerve pain from THIS incident was something beyond description. No patient should ever have to experience that — and, I think the biomedical design team at iFuse might entertain a letter describing my incident. It could only help them, and future patients.

If you’d like, I can send you a photo of the post-displacement incident, which shows the bolt “shoved” into the S-2 nerve outlet. You could share with colleagues, especially the one you’re friends with who’s performed many of these procedures. To what address could I send it so you could just see it? My surgeon prints off X-ray images for his patients, so this is literally an 8×10 piece of paper with the image on it.

Thanks for taking time to read my post, as always.

We’re thinking of you today here in the mountains of NC… Heavy snow and 50 mph winds. An awesome day to go outside on the walker and create a new sport for the X-Games… Freestyle Fuse ‘n Luge.

S.W., NC

[Donald Corenman, MD, DC]

#8276

Your logic is correct in that stabilization of this implant might help in the immediate post-operative period but there are structures that might not cooperate with stabilization (vessels and nerves). The other problem is that this joint is “soft”. That is, the bone that lines the sacroiliac joint does not lend to very strong fixation. Screw fixation is never as good as in the pedicles of the lumbar spine. However, fixation into the pelvis is very good for scoliosis fixation. You might have given me an idea. Thanks.

Dr. Corenman

PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
 
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.

[SpinelessWench]

#8278

Dr. Corenman,

If you’d like, I’d be happy to draft a letter / summary of what exactly happened in my situation, and include the radiograph copy I mentioned in my previous post above. I’ll address it to you directly if you’d please indicate what mailing address I should use. Feel free to share the letter and radiograph with your colleagues as you see fit. In short, I’m more than happy to share my experience with this mode of MIS for SIJD if it has the potential to help you, your surgical colleagues, and future patients.

And listen here… If your new “idea” includes a new patent and millions in royalties, don’t forget me …

I’ll send you my summary, etc., as soon as you reply with a mailing address.

Take care,

S.W., NC

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