Daniel Fell, Elias Diarbakerli, Paul Gerdhem


September 2022, pp 1 - 6 Original Article Read Full Article 10.1007/s00586-022-07341-5

First Online: 14 September 2022

Purpose

The aim of this study is to evaluate the levels of chromium (Cr), cobalt (Co), and titanium (Ti) after instrumented fusion for scoliosis.

Methods

Serum samples were collected at median 2.24 (range 0.1–38.8) years after fusion surgery for scoliosis in 91 individuals, of which 71 had been treated with steel implants and 20 with titanium implants. 91 sex and age-matched non-surgically treated individuals with scoliosis were used as controls. Levels of Cr, Co, and Ti were measured.

Results

In the 91 surgically treated individuals median levels of Cr were 0.54 µg/l vs 0 µg/l in the 91 controls, p 

In the individuals with steel implants and their corresponding controls median Cr levels were 0.63 µg/l vs. 0.00 µg/l, p 

In the individuals with titanium implants, median Cr levels were 0 µg/l vs. 0 µg/l in their corresponding controls, p = 0.38. Corresponding results for Co was 0.39 µg/l vs. 0.31 µg/l, p = 0.27 and for Ti 4.31 µg/l vs. 0 µg/l, p 

In the individuals with steel implants a negative correlation between implant time in situ and levels of Cr was found (ρ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\rho$$\end{document} = − 0.52, p 

In the individuals with titanium implants, there was no correlation between implant time in situ and levels of Cr (ρ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\rho$$\end{document} = 0.36, p = 0.12), Co (ρ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\rho$$\end{document} = − 0.12, p = 0.60) or Ti (ρ\documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\rho$$\end{document} = 0.22, p = 0.35).

Conclusion

The use of stainless steel and titanium implants in spinal fusion surgery is associated with elevated metal ion concentrations several years after surgery.


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