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ask: Could a Steffi Plate implanted in the back cause severe metal allergies?

By Curious
 
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Someone very close to me had back surgery when Steffi plates were newly introduced. Over the years there have been many health problems that have taken place: lactation of breasts without pregnancy; mental disorders including loss of memory, hearing voices, irratic behavior, etc.; and chrons disease to mention a few. She does have allergies to silver and nickel that I am aware of... so I am wondering if perhaps she could be allergic to the plate that was implanted in her back and maybe some of her symptoms are tied to that. The family has exhausted ideas and doctors all disagree on what is happening.

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EmpowHER Guest
Anonymous

I had a steffi plate back in 1989 for spondylolithesis s1 to l3 inclusive with bone graft. I would say I was symptom free for many years although I have had a number of medical issues that I possibly shouldn't have had in the interim years. Two years ago I had a bout of severe diahorria which lasted for six days, since then my back pain has been moderate to severe. In September 2013 I had another incident of severe debilitating back pain coupled with loose motions and fever which has left me in constant pain. I have tried every form of pain relief to manage the current situation with no effect. I'm currently trying morphine patches, no relief so far.
I do wonder if an in vitro reaction to the plate is taking place.

November 2, 2013 - 12:07am
EmpowHER Guest
Anonymous

Steffi plates are Stainless Steel spinal implants. There has been history to show that people with Nickel allergies can have reactions to stainless steel implants. I am only aware of a high white blood cell count and fatigue to the body fighting the allergy. I don't have enough information about metal allergies to agree or disagree with the fact that the allergy caused all of the unfortunate medical problems that you friend has had. If they can't decide on what the cause is, and her fusion is solid, then an orthopaedic or neuro spine surgeon can remove the plate pretty easily. I hope this helps.

May 22, 2013 - 3:51pm
EmpowHER Guest
Anonymous

Recent foot surgery (5 screws & plate)...then got rash & small ulcer where screws/plate were (just had removed).

Makes one think about QUESTIONING if wise to get metal screws/plate implanted (since may be allergic to it).

July 25, 2009 - 6:06am
Diane Porter

Hi, Curious. What a difficult time your friend/family member has had over the years. Whenever anything is complex and multi-layered, it seems harder to pick apart the pieces that could be caused by any one single element.

There is a book called Surgery of the Lumbar Spine, written by Sanford J. Larson and Dennis Maiman. Here is what it says about metal allergies:

"The increased use of metallic implants in surgery has led to concern regarding the development of allergic reactions or an adverse effect relating to a pre-existing metal allergy. Metal concentrations were increased in blood, urine, and adjacent tissue with metal-to-metal prostheses, but in patients with metal-to-plastic devices, blood and urine levels were normal and tissue levels only slightly elevated. Sensitivity did not develop following surgery. Metal allergy following spinal instrumentation has not been reported as a complication in any of the publications reviewed for this book, but has been observed in association with subcutaneous screws or screw plates. This is not surprising, since contact dermatitis is mediated by epidermal Langerhans cells. These cells can be reached by metallic ion either through the skin or from immediately beneath it but not in sufficient concentration from more distant locations. Although skin testing has been recommended for patients scheduled to have spinal instrumentation, this does not appear necessary. Patients with known metal allergies are usually apprehensive regarding spinal instrumentation but can be reassured that evidence to support this apprehension does not exist. Metal allergy is more common in women. However, of the 720 patients previously referred to, none developed cutaneous problems related to the implants, and the deep infection rate was 0.7% in men and 0.7% in women. The presents of metal allergy is not a contraindication even to subcutaneous implants, which can be removed if necessary after bone union has occurred, and certainly not to spinal instrumentation."

To help in translating that, cutaneous means on the skin, subcutaneous means beneath the skin, and Langerhans cells are certain cells contained in the skin.

As you can tell, this is a medical text, and is a bit difficult to work your way through. It's also an expensive book -- about $160 at Amazon. But it may be that your family would decide that that's worth the price for a detailed book about lumbar surgery and all its aspects (I imagine that the doctors' appointments over the years are much, much more expensive than that.)

Here's the Amazon link if you are interested in reading more about the book:

http://www.amazon.com/Surgery-Lumbar-Spine-Sanford-Larson/dp/0865777586/...

So, that book seems to say that metal allergies with lumbar procedures aren't a big issue. But it's always possible that your family member/friend is part of the 0.7%, yes? Has she been tested for an allergy to whatever metals are in her body (including the implant AND screws used to attach the implant?) Have the metals levels in her blood been tested?

Can you tell us how old this person is? How old was she at the time the surgery was done? And were none of mental behaviors present before her implant? Was it something that was noticed very soon after the implant, or has it just happened over time?

Something that may need to be tested is the hormone levels in her blood. Has this ever been done? I ask because lactation without pregnancy can be a hormone-related issue, usually caused by high levels of the hormones responsible for production of milk. Was this a short-term problem? What was done to help solve it? Was she on a course of medication at the time? (Hormone levesl can also be affected by certain medications. For instance, domperidone, a medication originally used to treat upper gastrointestinal problems, triggers the production of prolactin, which triggers lactation.) Since she had Chron's disease, is it possible she was on this medicine at that time?

Here's a page on lactation without pregnancy:

http://www.aboutkidshealth.ca/News/Breastfeeding-without-pregnancy.aspx?...

Hearing voices and erratic behavior can be caused by a lot of different mental disorders. What sort of erratic behavior have you seen? Do her doctors include a psychiatrist? What sort of theories have they explored in the past?

We'd be happy to do some more research here. Give us a bit more info and let's see if we can help some more.

February 1, 2009 - 11:40am
Susan Cody HERWriter Guide

Hi Curious -

Thank you for your question. I'm trying to find out what a steffi plate is made of. Is it steel? Can you have your friend tell you?

Did all of her problems start after the plate was inserted?

A person can be allergic to almost anything, and it can happen at any stage in life.

If she is in fact, allergic to the steffi plate (something one would hope would have been looked into, before it was implanted) then her body will probably continue to look for ways to reject it. Once a person has an allergy to a metal, it's unlikely they'll grow out of it.

People have, in fact, suffered due to allergies from surgical metal implant devices. The FDA has received information regarding a serious allergy to a stent implanted in a woman during heart surgery. Women suffer from metal allergies more often than men. The allergy symptoms with this woman were not ones of mental health, they were all physical.

On the other hand, your friend may have a mental illness, based on what you said, regarding hearing voices and erratic behavior, that has nothing to do with the insertion of a steffi plate. And with regard to Chron's - it's unlikely to be connected. Up to two million people in America suffer from Inflammatory Bowel Disease (including Chron's).

But your theory may have merit. If you can give us more information about the steffi plate itself, we can look into this further, although I suspect it is probably made from stainless steel. Does your friend know if she has an allergy to this? Please update us a little more!

January 31, 2009 - 1:05pm
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