%0 Case Reports
%T Metallosis with spinal implant loosening after spinal instrumentation: A case report.
%A Kwan YH
%A Teo HLT
%A Dinesh SK
%A Loo WL
%J World J Orthop
%V 14
%N 8
%D 2023 Aug 18
%M 37662668
暂无%R 10.5312/wjo.v14.i8.651
%X <B>BACKGROUND: </B>Spinal metallosis is a rare complication following spinal instrumentation whereby an inflammatory response to the metal implants results in the development of granulomatous tissue.<BR><B>METHODS: </B>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.<BR><B>CONCLUSIONS: </B>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.