Evidence map›Paper›PMID 41989536›Full record

Observational studySpine deformity2026

Effect of mixing dissimilar metals on serum metal ion levels following spinal deformity surgery.

Jennifer C Urquhart, Vahagn Karapetyan, Firoz Miyanji, Omar Siddiqi, Karim Kantar, Timothy Carey, Christopher S Bailey, Ravi Ghag, Brent Lanting, Supriya Singh and 1 more

Abstract readMulticenter StudyObservational Study
PubMed Publisher
In one paragraph

Observational study in Spine deformity, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jennifer C UrquhartSchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada.
Vahagn KarapetyanSchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada.
Firoz MiyanjiDepartment of Orthopaedics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Omar SiddiqiSchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada.
Karim KantarDepartment of Orthopaedics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Timothy CareySchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada.
Christopher S BaileySchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada.
Ravi GhagDepartment of Orthopaedics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
Brent LantingSchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada.
Supriya SinghSchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada.
Parham RasoulinejadSchulich School of Medicine, London Health Sciences Centre Combined Neurosurgical and Orthopaedic Spine Program, Victoria Hospital, Western University, London, Ontario, Canada. Parham.Rasoulinejad@lhsc.on.ca.ORCID http://orcid.org/0000-0002-3031-2633

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe increased use of hybrid spinal implants combining dissimilar metals raises concerns for galvanic corrosion, which can affect metal ion release and implant longevity. This study examines the variation in post-fusion metal ion concentrations among different hybrid implant constructs.

methodsIn this prospective multicenter observational study, patients undergoing elective surgery for idiopathic or neuromuscular scoliosis received either cobalt-chromium (CoCr/Ti) or stainless steel (SS/Ti) rods with titanium screw implants. Blood metal ion concentrations were measured preoperatively and at 3, 12 and 24 months. Longitudinal data were analyzed using linear mixed-effects models adjusted for repeated measures.

resultsA total of 37 patients were enrolled in the CoCr/Ti group and 35 in the SS/Ti group, with a majority of females (68% in CoCr/Ti vs. 71% in SS/Ti). There were no significant differences between the groups in age, BMI, number of rod attachments or rod surface area. Chromium (Cr) levels initially increased then plateaued, remaining consistently higher in the SS/Ti group, and significantly above baseline at 24 months. Cobalt (Co) concentrations also initially increased in both groups, but were higher in CoCr/Ti. Titanium (Ti) levels increased in both groups but continued to show a positive trajectory in CoCr/Ti at 24 months. Higher titanium concentrations also correlated with the number of rod attachments and instrument-related complications in CoCr/Ti but not the SS/Ti group.

conclusionsWith consideration of the different material properties in hybrid implant components, our findings suggest that differences in surface hardness appear to be more pertinent to metallic wear than galvanic corrosion.

Indexed as

MetalsScoliosisSpinal FusionAdolescentBone ScrewsChromiumChromium AlloysCobaltFemaleHumansIonsMaleProspective StudiesStainless SteelTitaniumChromiumChromium AlloysCobaltIonsMetalsStainless SteelTitaniumCobalt chromiumHybrid spinal implantsIdiopathic scoliosisMetal ion releaseNeuromuscular scoliosisStainless steelTitanium

Identifiers

PMID41989536

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.