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-   -   GELs in future in spine surgery article (http://www.ispine.org/forum/ispine/2103-gels-future-spine-surgery-article.html)

cherylstewart67 06-23-2011 11:39 PM

GELs in future in spine surgery article
 
Gels are becoming the tools of the future in spine surgery and back pain management
Spine surgery is increasingly at the crossroads of medicine and technology, and the latest discovery from researchers at the University of California Davis is there to prove it.

One of the most dangerous side effects of back surgery are spinal fluid leaks through minuscule holes that may be left by surgical instruments. Not only can these leaks be painful in themselves, but they also increase the risk of infections such as meningitis. Often, patients who experience spinal fluid leaks need to undergo a second surgery to repair them, resulting in more wounds that need to heal and additional recovery time.

So it is no wonder that scientists have been hard at work to figure out ways to prevent such leaks in the first place.

In recent months, 24 medical centers throughout the U.S. tested the effectiveness of a hydrogel sealant made out of polyethylene glycol (PEG).

Operating surgeons used the substance as a complement during the suturing of the dura, which is a sheath inside the spinal column that encloses and protects the spinal cord. Any holes left in the dura as a result of a surgical intervention can cause the spinal fluid to leak out.

The researchers found that 100 percent of the patients who received the PEG hydrogel sealant had a watertight closure - meaning no leaks - as opposed to only 64 percent of those who received standard care, which included using additional stitches to close the holes.

Kee Kim, an associate professor of neurological surgery at the School of Medicine at UC Davis and chief of spinal neurosurgery and co-director of the UC Davis Spine Center, says the gel is not only effective but also safe because it is synthetic. This eliminates any risk of disease transmission or immune system rejection issues that are sometimes encountered with animal-derived or human-donated tissue.

The gel, which is a liquid that solidifies and creates a tight seal when it comes into contact with the body, was approved for use by the Food and Drug Administration in 2010.

The current study, which was published in the journal Spine, follows another project from researchers at the University of Manchester in the UK who successfully tested the use of an elastic gel to relieve chronic back pain symptoms.

Based on nanoscopic polymer particles that are injected into the affected part of the spine, the gel was shown in clinical studies to be able to replace an intervertebral disc. This property stems from its flexibility that allows for natural movements of the spine. The gel is also durable, which is a basic requirement for an implant. Finally, just like the PEG gel, it is synthetically manufactured.

Individuals who require disc replacement are typically those who have been diagnosed with disc degeneration, bulging or herniation, conditions that account for most chronic back pain symptoms. Up until now, many of these patient have only been able to find sufficient relief with invasive spine surgery.

Maria 06-24-2011 03:03 PM

re PEG
 
Cheryl,
PEG 3350.. know what that is?? Miralax! So I'm using something that's used in a sealant as a laxative! Well I'm sure many things have multiple uses!:rolleyes:

In all seriousness, thanks for the info!

dshobbies 06-24-2011 05:39 PM

Just for my own claification - the diseased disc is removed and replaced by only this gel?

If this is true - wow!

mmglobal 06-24-2011 09:21 PM

Removing my INCORRECT comments!

cherylstewart67 06-25-2011 12:30 PM

no
 
Quote:

Originally Posted by dshobbies (Post 14953)
Just for my own claification - the diseased disc is removed and replaced by only this gel?

If this is true - wow!

it is used to repair the disc where it stands. it is to keep from having to remove it or at least prolong that.

mmglobal 06-25-2011 03:43 PM

OK... I should have read the entire article!

This will be interesting. If they inject the gel and successfully 'seal' the disc, that will not resolve the issues related to the endplates no longer hydrating the disc and degenerated nucleus material. Will the gel remain as something like a pseudo nucleus?

My guess is that this will be much like so many other of the promising treatments.... that most of us will be too far down the degenerative cascade for this to be effective. I hope I'm wrong.

Mark

jbcool35 07-31-2011 09:23 PM

Anything with poly in front of it probably doesn't belong in the body. Polyurethane and may many other Poly's are known to cause cancer. Why don't they do something like grow us a new disc using our own DNA? They are doing that with heart valves, bladders, etc. When are they gonna get around to us? When are they actually gonna really study things that need to be done? I see a lot of studies and none of them address anything real. It is always ADR or an ancient surgery like fusion.

I don't know about you guys, but I'm not holding my breath! I know I sound negative but look at the world today. Do you think they are really gonna do anything for us? What if the financial system fails? There will be no more pain management, surgeries, studies. Then when this Universal healthcare comes into play, forget it. It will be worse than the VA and medicare put together. That is one of the main reasons I'm tapering my medicine. I'm in pain but I sure don't need any withdrawals adding to it if I can't get my medicine anymore.

Don't mean to bring anyone down. Just another way of looking at things. To me it's just one big cabal. Doctors tend to not cure people just treat their symptoms. There is no money in curing people. Sure there are a select few doctors that try and they get the shaft by the establishment. Especially in the United States where I live.

Just to prove my point. I had a heart doctor even admit that to me. He said i would have to be on Liptior and Lopressor the rest of my life cause it is genetic. I said whatever. After researching it, I found out a low carb diet cured me and I got off all those meds. I told the doctor and he said, ideally that's the kinda diet everyone should follow. So what the heck! They all get kick backs from big pharma to push certain meds and devices. Hard to know what to believe. Sorry about the rant. Just my 2 cents.

mmglobal 08-01-2011 02:16 AM

Why don't they just grow us a new disc? They have been working on that for some time now. My first surgeon's conference was in December 2002 when I went to AAMISMS. (American Academy of Minimally Invasive Spine Medicine & Surgery)

Dr. Bertagnoli showed slides of 'recovered' discs that had been previously degenerated, but were again nicely hydrated and healthy looking. These were following the ADCT procedure in which they harvest your own disc nucleus during a standard micro or endo discectomy, then culture your own cells in a lab. 6 - 12 weeks later, they implant 20,000 times the number of cellls than were harvested.

I was blown away by what I saw and was very excited to see how this was going to pan out. 9 years later, I'm still waiting for the splash.

The technology exists to get your to grow new disc material, but unfortunately, the nucleus is just one component of a system Most of us are too far gone for this procedure to be successful before we even know we have a problem. They are no longer passing water and nutrients to the nucleus in sufficient quantities to keep the nucleus healthy. The 'black disc' or dehydrated disc is a symptom of the entire system failing, not just the nucleus. Replacing the nucleus is not enough.

I have seen case presentations where cadaver discs were havested INCLUDING the vertebral endplates, and impanted into patients with severe DDD. These transplants were successful.



I've had several clients get the procedure done.

jbcool35 08-01-2011 07:13 AM

Sorry, I was just on a rant which I usually don't go on. I apologize, just frustrated. I wasn't aware of that procedure. Thanks for setting me straight though. It give me hope to know they are trying. I hope one day it will come to be.

dshobbies 08-01-2011 05:08 PM

Sometimes we all just need to get it out. I don't know why but it does seem cathartic. Go figure! I guess it's like screaming to vent your frustration but put into words instead.

blg814 10-07-2011 05:16 AM

But ...
 
Can you use this stuff if you have had surgery already. L4,L5 microdiscectomy back in 02. It relieved mind-crushing sciatica, but still left my foot numb and de sensitized. Feels like my foot is being squeezed in a ski boot thats too small...all the time. :(

dshobbies 10-07-2011 05:28 PM

My foot too seems squeezed and feels on fire all the time. Mine is nerve damage and this is it.

Have you tried Neurontin or Lyrica? If you don't mind the side effects, both might be extremely successful with eliminating your pain.

Dale


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