Metallosis with spinal implant loosening after spinal instrumentation: A case report.
| Autor: | Kwan YH; Department of Orthopaedic Surgery, Changi General Hospital, Singapore 529889, Singapore. yiuhin@gmail.com., Teo HLT; Department of Orthopaedic Surgery, Changi General Hospital, Singapore 529889, Singapore., Dinesh SK; Department of Orthopaedic Surgery, Changi General Hospital, Singapore 529889, Singapore., Loo WL; Department of Orthopaedic Surgery, Changi General Hospital, Singapore 529889, Singapore. |
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| Jazyk: | angličtina |
| Zdroj: | World journal of orthopedics [World J Orthop] 2023 Aug 18; Vol. 14 (8), pp. 651-661. Date of Electronic Publication: 2023 Aug 18 (Print Publication: 2023). |
| DOI: | 10.5312/wjo.v14.i8.651 |
| Abstrakt: | Background: Spinal metallosis is a rare complication following spinal instrumentation whereby an inflammatory response to the metal implants results in the development of granulomatous tissue. Case Summary: We describe the case of a 78-year-old woman who had recurrence of back pain 5 years after lumbar spine posterior decompression and instrumented fusion. Lumbar spine radiographs showed hardware loosening and magnetic resonance imaging showed adjacent segment disease. Revision surgery revealed evidence of metallosis intraoperatively. Conclusion: Spinal metallosis can present several years after instrumentation. Radiography and computed tomography may demonstrate hardware loosening secondary to metallosis. Blood metal concentrations associated with spinal metallosis have yet to be established. Hence, metallosis is still an intraoperative and histopathological diagnosis. The presence of metallosis after spinal instrumentation likely indicates a more complex underlying problem: Pseudarthrosis, failure to address sagittal balance, infection, and cross-threading of set screws. Hence, identifying metallosis is important, but initiating treatment promptly for symptomatic implant loosening is of greater paramount. Competing Interests: Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose. The authors declare that no funds, grants, or other support were received during the preparation of this manuscript. (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.) |
| Databáze: | MEDLINE |
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