Metal levels in corrosion of spinal implants

被引:55
作者
del Rio, Javier [1 ]
Beguiristain, Jose [1 ]
Duart, Julio [1 ]
机构
[1] Univ Navarra Clin, Dept Orthoped Surg & Traumatol, Navarra 31008, Spain
关键词
corrosion; spinal implants; metal levels;
D O I
10.1007/s00586-007-0311-4
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Corrosion affects spinal instrumentations and may cause local and systemic complications. Diagnosis of corrosion is difficult, and nowadays it is performed almost exclusively by the examination of retrieved instrumentations. We conducted this study to determine whether it is possible to detect corrosion by measuring metal levels on patients with posterior instrumented spinal fusion. Eleven asymptomatic patients, with radiological signs of corrosion of their stainless steel spinal instrumentations, were studied by performing determinations of nickel and chromium in serum and urine. Those levels were compared with the levels of 22 patients with the same kind of instrumentation but without evidence of corrosion and to a control group of 22 volunteers without any metallic implants. Statistical analysis of our results revealed that the patients with spinal implants without radiological signs of corrosion have increased levels of chromium in serum and urine (P < 0.001) compared to volunteers without implants. Corrosion significantly raised metal levels, including nickel and chromium in serum and urine when compared to patients with no radiological signs of corrosion and to volunteers without metallic implants (P < 0.001). Metal levels measured in serum have high sensibility and specificity (area under the ROC curve of 0.981). By combining the levels of nickel and chromium in serum we were able to identify all the cases of corrosion in our series of patients. The results of our study confirm that metal levels in serum and urine are useful in the diagnosis of corrosion of spinal implants and may be helpful in defining the role of corrosion in recently described clinical entities such as late operative site pain or late infection of spinal implants.
引用
收藏
页码:1055 / 1061
页数:7
相关论文
共 29 条
[1]   Corrosion of spinal implants retrieved from patients with scoliosis [J].
Akazawa, T ;
Minami, S ;
Takahashi, K ;
Koiani, T ;
Hanawa, T ;
Moriya, H .
JOURNAL OF ORTHOPAEDIC SCIENCE, 2005, 10 (02) :200-205
[2]   CORROSION OF THE HARRINGTONS INSTRUMENTATION AND BIOLOGICAL BEHAVIOR OF THE ROD - HUMAN SPINE SYSTEM [J].
AULISA, L ;
DIBENEDETTO, A ;
VINCIGUERRA, A ;
LORINI, G ;
TRANQUILLILEALI, P .
BIOMATERIALS, 1982, 3 (04) :246-+
[3]   Survivorship analysis of Cotrel-Dubousset instrumentation in idiopathic scoliosis [J].
Bago, J ;
Ramirez, M ;
Pellise, F ;
Villanueva, C .
EUROPEAN SPINE JOURNAL, 2003, 12 (04) :435-439
[4]   Nickel [J].
Barceloux, DG .
JOURNAL OF TOXICOLOGY-CLINICAL TOXICOLOGY, 1999, 37 (02) :239-258
[5]   Chromium [J].
Barceloux, DG .
JOURNAL OF TOXICOLOGY-CLINICAL TOXICOLOGY, 1999, 37 (02) :173-194
[6]   Corrosion and late infection causing delayed paraparesis after spinal instrumentation [J].
Beguiristain, Jose ;
Del Rio, Javier ;
Duart, Julio ;
Barroso, Jose ;
Silva, Alvaro ;
Villas, Carlos .
JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B, 2006, 15 (05) :320-323
[7]   Late-developing infection in instrumented idiopathic scoliosis [J].
Clark, CE ;
Shufflebarger, HL .
SPINE, 1999, 24 (18) :1909-1912
[8]   Reoperation after primary posterior instrumentation and fusion for idiopathic scoliosis - Toward defining late operative site pain of unknown cause [J].
Cook, S ;
Asher, M ;
Lai, SM ;
Shobe, J .
SPINE, 2000, 25 (04) :463-468
[9]  
Doorn PF, 1996, CLIN ORTHOP S, V329S, P187
[10]  
Dubousset J., 1994, ORTHOP T, V18, P121