Predictors of Serum Chromium Levels After Stainless Steel Posterior Spinal Instrumentation for Adolescent Idiopathic Scoliosis

Rackham, Matthew; Cundy, Thomas P.; Antoniou, Georgia; Freeman, Brian J. C.; Sutherland, Leanne M.; Cundy, Peter

doi:10.1097/brs.0b013e3181d7a197

Cited by 19 publications

(13 citation statements)

References 30 publications

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“…Studies of metal ion levels in patients with spinal implants are less numerous. There have been only a few retrospective reports of metal ion levels in patients with stainless steel [18][19][20][21][22] and titanium [23,24] posterior spinal instrumentation. Less is known for metalon-metal total disc arthroplasty [25][26][27].…”

Section: Introductionmentioning

confidence: 99%

“…A study by del Rio et al [19] described similarly elevated serum nickel and chromium levels in patients with instrumented spinal arthrodesis, noting the correlation between significantly higher metal ion levels and radiological signs of device corrosion. Rackham et al [21] determined that the number of metal connections/interfaces was positively correlated with serum chromium levels in a group of 30 patients undergoing posterior spinal arthrodesis.…”

Section: Introductionmentioning

confidence: 99%

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Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty

et al. 2012

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Purpose Metal-on-metal total disc replacement is a recent alternative treatment for degenerative disc disease. Wear and corrosion of these implants can lead to local and systemic transport of metal debris. This prospective longitudinal study examined the serum chromium and cobalt levels in 24 patients with cobalt-chromium alloy metal-onmetal lumbar disc replacements. Methods Serum was assayed for chromium (Cr) and cobalt (Co) using high-resolution inductively-coupled plasma-mass spectrometry. Detection limits were 0.015 ng/ mL for Cr and 0.04 ng/mL for Co. Results Median serum Co levels at pre-op, 3, 6, 12, 24, and 36-months post-op were 0.10, 1.03, 0.96, 0.98, 0.67, and 0.52 ng/mL, respectively. Median serum Cr levels were 0.06, 0.49, 0.65, 0.43, 0.52, and 0.50 ng/mL, respectively. Conclusion In general, these results indicated that serum Co and Cr levels are elevated at all postoperative time points and are of the same order of magnitude as those observed in well-functioning metal-on-metal surface replacements of the hip and in metal-on-metal total hip replacements at similar postoperative time points.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty

et al. 2012

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“…These results suggest that this novel mobile-head screw shows high-level durability and histological safety; however, as the serum titanium level increased to 2-3 times the preimplantation control level, sufficient follow-up is considered necessary. It is known that the concentrations in the metal serum increase by size and the number of internal implants [13]. Also, though the long-term course is unknown, it is reported that the concentrations in the metal serum do not increase gradually at least with age [14].…”

Section: Discussionmentioning

confidence: 99%

A Novel Pedicle Screw with Mobile Connection: A Pilot Study

Tokuhashi

Oshima

Ajiro

et al. 2014

BioMed Research International

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To prevent adjacent disc problems after spinal fusion, a pedicle screw with a mobile junction between the head and threaded shaft was newly developed. The threaded shaft of the screw has 10 degrees mobility in all directions, but its structure is to prevent abnormal translation and tilting. This screw was evaluated as follows: (1) endurance test: 106 times rotational stress was applied; (2) biological reactions: novel screws with a mobile head and conventional screws with a fixed head were inserted into the bilateral pedicles of the L3, L4, and L5 in two mini pigs with combination. Eight months after surgery, vertebral units with the screw rod constructs were collected. After CT scan, the soft and bony tissues around the screws were examined grossly and histologically. As a result, none of the screws broke during the endurance test stressing. The mean amount of abrasion wear was 0.0338 g. In the resected mini pig section, though zygapophyseal joints between fixed-head screws showed bony union, the amount of callus in the zygapophyseal joints connected with mobile-head screws was small, and joint space was confirmed by CT. No metalloses were noted around any of the screws. Novel screws were suggested to be highly durable and histologically safe.

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“…Also concerning, recent studies have demonstrated elevated chromium levels in patients who have had fusion with stainless steel implants 73 and that these levels appear to be related to the amount of material used during fusions 74 . The implications of higher chromium levels are unknown, but high levels in animals have carcinogenic and mutagenic effects.…”

Section: Spinementioning

confidence: 99%

“…The implications of higher chromium levels are unknown, but high levels in animals have carcinogenic and mutagenic effects. Long-term follow-up is needed, although chromium levels do appear to decrease over time 74 .…”

Section: Spinementioning

confidence: 99%