ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2022
Serum metal ion levels following spinal deformity surgery: a case-control study of 182 individuals.
Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 8 citations in OpenAlex.
- Early postoperative serum metal profiles and subsequent revision-related surgery after instrumented fusion for adolescent idiopathic scoliosis.International orthopaedics · 2026Article
- Effect of mixing dissimilar metals on serum metal ion levels following spinal deformity surgery.Spine deformity · 2026Observational
- Advancements in biomaterials and bioactive solutions for lumbar spine fusion cages: Current trends and future perspectives.Bioactive materials · 2025Review
- Comparison of blood metal ion levels in scoliosis patients following instrumented spinal fusion with cobalt-chromium and titanium alloy rods.Scientific reports · 2025Article
- Spinal implant wear particles: Generation, characterization, biological impacts, and future considerations.iScience · 2025Review
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study is to evaluate the levels of chromium (Cr), cobalt (Co), and titanium (Ti) after instrumented fusion for scoliosis.
methodsSerum 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.
resultsIn the 91 surgically treated individuals median levels of Cr were 0.54 µg/l vs 0 µg/l in the 91 controls, p < 0.001. Corresponding results for Co were 0.29 µg/l vs. 0.24 µg/l, p = 0.19, and for Ti were 0 µg/l vs. 0 µg/l, p < 0.001. In the individuals with steel implants and their corresponding controls median Cr levels were 0.63 µg/l vs. 0.00 µg/l, p < 0.001 and Co levels 0.27 µg/l vs. 0.23 µg/l, p = 0.36. No Ti was detected. 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 < 0.001. In the individuals with steel implants a negative correlation between implant time in situ and levels of Cr was found ([Formula: see text] = - 0.52, p < 0.001) but not with Co ([Formula: see text] = - 0.14, p = 0.23). Ti was not detected. In the individuals with titanium implants, there was no correlation between implant time in situ and levels of Cr ([Formula: see text] = 0.36, p = 0.12), Co ([Formula: see text] = - 0.12, p = 0.60) or Ti ([Formula: see text] = 0.22, p = 0.35).
conclusionThe 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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