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Pros Cons Titanium Myeloma
What are the pros and cons of using titanium for myeloma bone damage? You’ve been diagnosed with a blood cancer called multiple myeloma. The MM has damaged one or more of your bones, and your doctor is suggesting he/she use titanium to support the bone so it can heal.
But before you have titanium put into your body, you’d like to know something about this metal.
A lytic lesion destroyed my C5 so I had a titanium strut screwed into my C4 and C6 to take the place of my C5. No pain, no side effects since my surgery in early 1994.
What are the risks and benefits of titanium use in myeloma bone damage?
Titanium is commonly used in orthopedic surgery, including in cases of bone damage caused by multiple myeloma, especially for spinal stabilization or fixation. However, its use comes with both benefits and risks, which should be carefully considered in collaboration with an oncology and orthopedic team.
✅ Benefits of Titanium Use in Myeloma Bone Damage
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High Strength and Durability
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Titanium is strong yet lightweight, providing long-term structural support in areas weakened by myeloma lesions.
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Biocompatibility
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It is highly biocompatible, meaning it is well tolerated by the body with a low risk of allergic reactions or immune responses.
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Corrosion Resistance
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Titanium resists degradation inside the body, making it suitable for long-term implantation.
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Support for Stabilization
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In spinal or long bone lesions, titanium implants (rods, cages, plates) help stabilize fractures or impending fractures, improving mobility and reducing pain.
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MRI Compatibility
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Titanium is non-ferromagnetic and generally safe for MRI scans, which are frequently used in myeloma monitoring.
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⚠️ Risks and Limitations
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Interference with Imaging
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While MRI-safe, titanium can still cause some artifacts in CT scans, potentially interfering with an evaluation of disease progression near the implant.
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Non-Remodeling Material
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Unlike bone grafts or some bioresorbable materials, titanium does not integrate or remodel into bone; it’s a permanent fixture unless removed surgically.
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Infection Risk
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Any surgical implant carries a risk of postoperative infection, which can be more serious in immunocompromised myeloma patients.
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Surgical Risk in Fragile Bone
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Myeloma often leads to fragile or lytic bone, making implant fixation more difficult and increasing the risk of implant failure or additional fractures.
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Does Not Treat Underlying Disease
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Titanium provides structural support only; it does not impact tumor activity or bone remodeling, so systemic treatment (e.g., bisphosphonates, chemotherapy) remains essential.
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Clinical Context
Titanium implants are typically used:
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In spinal stabilization after vertebral collapse due to lytic lesions.
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In long bone fixation, when a fracture is present or at high risk.
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In combination with radiation or systemic therapy to address the underlying disease.
I am a long-term MM survivor. Email me at David.PeopleBeatingCancer@gmail.com with questions about your MM, your treatment, etc.
Thanks,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Consensus on Surgical Management of Myeloma Bone Disease
“Myeloma bone disease (MBD), the skeletal lesions caused by multiple myeloma, is also known as skeletal-related events and includes
- bone pain,
- osteoporosis,
- pathological fractures,
- osteolytic bone lesions,
- spinal instability,
- spinal cord and nerve root compression and
- extramedullary plasmacytoma.
It is now generally accepted that patients with these complications usually require surgical management and that such treatment is safe and effective. The aims of surgical interventions are to
- alleviate pain,
- improve quality of life,
- treat potential or existing pathological fractures,
- decompress the spinal cord and nerve roots,
- and reestablish bone continuity.
Thus far, there have not been uniform standards for surgical treatment of MBD. The Surgeon’s Committee of the Chinese Myeloma Working Group has therefore achieved a consensus with the aim of providing guidance for clinicians and benefitting patients with MBD.
This consensus focuses on the treatment of MBD, including its clinical definition and characteristics, diagnosis and surgical management. This expert consensus document was compiled after discussion and revision by experts from several relevant institutions in China. However, it is only an interim guide that cannot be enforced legally. It will be updated with the development of new techniques of treatment…
Definition of MBD
MBD, the skeletal lesions caused by multiple myeloma, is also known as skeletal-related events and includes bone pain, osteoporosis, pathological fractures, osteolytic bone lesions, spinal instability, spinal cord and nerve root compression and extramedullary plasmacytomas…
Titanium-
Fixators made of titanium are recommended because they do not impair follow-up assessment by MRI. In addition to facilitating shaping, bone cement can kill tumor cells; it is therefore the first choice for implanting in bone defects after removing tumor masses.
Open surgery can reduce the internal pressure of bone and the dough stage of bone cement can reduce the risk of pulmonary embolism. Autologous bone grafts are not recommended because they are more likely to be absorbed in patients with MBD2.
A combination of open spinal and minimally invasive surgery is typically used to treat patients with multiple MM spinal lesions, because this has the advantages of both types of surgery, decreasing bleeding volume and other complications. The main goal of such procedures is to reestablish spine stability, reduce bone tumor mass and decompress the spinal cord; wide or radical resection is unnecessary for MBD of the spine.
The patient’s general condition and prognosis must be considered preoperatively and reconstruction methods chosen according to the patient’s specific needs. Spine surgery is highly risky and demanding; thus, it is very important that surgeons performing it are experienced in spinal tumor surgery…
Surgery for Pathological Fractures of the Long Bones
The benefits of surgical treatment for pathological fractures of long limb bones include pain relief, restoration of bone continuity and limb function and improved quality of life. Appropriate surgical procedures include resection or curettage of bone lesions, filling of defects with bone cement and internal fixation as indicated with screws, titanium plates, intramedullary nails or interlocking intramedullary nails and so on34…
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