Will the metal detectors go off when I walk through airport security? That’s a question I often get from patients who are contemplating spine fusion surgery. It’s not an unreasonable question, as fusion usually involves placing metal plates, screws, and cages. The answer to this question is: “No.” But I do always use the opportunity to talk a bit about spine implants, and the latest technology.
There are many different ways to perform a fusion operation. I think it’s easiest to talk about them through case examples. I’ve attached three intra-operative radiographs of cervical spine or neck fusions in patients who had severe neck pain radiating down their arm, associated with numbness and tingling in their hands. These patients had tried everything to get rid of their pain — medications, physical therapy, and injections — and unfortunately, nothing worked. They opted for surgery to get rid of the arthritic discs and bony spurs pinching their nerves.
The first X-ray shows a fusion with a titanium plate and screws buttressing cadaveric bone spacers placed between the vertebral bodies, after removing their arthritic disc. The second X-ray shows a fusion with the same titanium plate, but this time using a 3D-printed titanium mesh cage that is porous to promote bone growth. The last X-ray shows a fusion, using an interbody spacer with new technology called “porous PEEK,” a special inert plastic with holes of a particular size that ultimately helps promote bone growth.
Whether older methods, such as the cadaveric bone spacer, or the latest in 3D-printing technology with the titanium or porous PEEK cages, the outcomes of these operations are usually fantastic. All three patients woke up with a significant reduction in their preoperative pain.
My role as a spine surgeon is to choose the best option based on the patients’ characteristics. For healthy patients with no social risk factors (e.g., smoking), cadaveric bone works well, and it is cheaper. For those who may have weaker bone or problems forming bone (e.g., smokers and patients over 65 years of age), using the porous PEEK, which better matches the cervical spine mechanics, could be a better choice.
Whatever choice is best, I can definitively say patients shouldn’t worry at all about TSA and the metal detectors. Travel (safely) with confidence!
Uchechi Iweala MD, MBA
Orthopedic Spine Surgeon
Centers for Advanced Orthopedics
Orthopedic Associates of Central Maryland Division