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

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.

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.

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).

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/ref=sr_11_1?ie=UTF8&qid=1233511844&sr=11-1

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?articleID=10084&categoryID=news-type

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.