ArticleBMC musculoskeletal disorders2012
The development of whole blood titanium levels after instrumented spinal fusion - is there a correlation between the number of fused segments and titanium levels?
Article in BMC musculoskeletal disorders, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- A systematic review of metal ion concentrations following instrumented spinal fusion.Spine deformity · 2021Pooled it
- Evaluation of Titanium Particles, TNF-α, and Caspase-3 Concentrations in Patients with Bones Fixations of the Maxilla and Mandibule.International journal of molecular sciences · 2025Article
- Associations between Non-Essential Trace Elements in Women's Biofluids and IVF Outcomes in Euploid Single-Embryo Transfer Cycles.Journal of xenobiotics · 2024Article
- Endothelialization and Inflammatory Reactions After Intracardiac Device Implantation.Advances in experimental medicine and biology · 2022Review
- Analysis of serum levels of titanium and aluminium ions in patients with early onset scoliosis operated upon using the magnetic growing rod-a single centre study of 14 patients.Spine deformity · 2021Article
- Are Titania Photocatalysts and Titanium Implants Safe? Review on the Toxicity of Titanium Compounds.Nanomaterials (Basel, Switzerland) · 2020Review
- Article
- Exploring titanium(IV) chemical proximity to iron(III) to elucidate a function for Ti(IV) in the human body.Coordination chemistry reviews · 2018Article
- Evaluation of Blood Titanium Levels and Total Bone Contact Area of Dental Implants.BioMed research international · 2018Article
- Titania-catalyzed radiofluorination of tosylated precursors in highly aqueous medium.Journal of the American Chemical Society · 2015Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost modern spinal implants contain titanium and remain in the patient's body permanently. Local and systemic effects such as tissue necrosis, osteolysis and malignant cell transformation caused by implants have been described. Increasing tissue concentration and whole blood levels of ions are necessary before a disease caused by a contaminant develops. The aim of the present study was the measurement of whole blood titanium levels and the evaluation of a possible correlation between these changes and the number of fused segments.
methodsA prospective study was designed to determine changes in whole blood titanium levels after spinal fusion and to analyze the correlation to the number of pedicle screws, cross connectors and interbody devices implanted.Blood samples were taken preoperatively in group I (n = 15), on the first, second and 10th day postoperatively, as well as 3 and 12 months after surgery.Group II (n = 16) served as a control group of volunteers who did not have any metal implants in the body. Blood samples were taken once in this group.The number of screw-rod-connections and the length of the spinal fusion were determined using radiographic pictures. This study was checked and approved by the ethical committee of the University of Tuebingen.
resultsThe mean age in group I was 47 ± 22 years (range 16 - 85 years). There were three male (20%) and twelve female (80%) patients. The median number of fused segments was 5 (range 1 to 11 segments).No statistically significant increase in the titanium level was seen 12 months after surgery (mean difference: -7.2 μg/l, 95% CI: -26.9 to 12.5 μg/l, p = 0.446). By observing the individual titanium levels, 4 out of 15 patients demonstrated an increase in titanium levels 12 months after surgery.No statistically significant correlation between fused segments (r = -0.188, p = 0.503) length of instrumentation (r = -0.329, p = 0.231), number of interbody devices (r = -0.202, p = 0.291) and increase of titanium levels over the observation period was seen.
conclusionsInstrumented spinal fusion does not lead to a statistically significant increase in whole blood titanium levels. There seems to be no correlation between the number of pedicle screws, cross connectors and interbody devices implanted and the increase of serum titanium levels.
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