Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/61676
Citations
Scopus Web of Science® Altmetric
?
?
Type: Journal article
Title: Chromium ion release from stainless steel pediatric scoliosis instrumentation
Author: Cundy, T.
Delaney, C.
Rackham, M.
Antoniou, G.
Oakley, A.
Freeman, B.
Sutherland, L.
Cundy, P.
Citation: Spine, 2010; 35(9):967-974
Publisher: Lippincott Williams & Wilkins
Issue Date: 2010
ISSN: 0362-2436
1528-1159
Statement of
Responsibility: 
Thomas P. Cundy, Christopher L. Delaney, Matthew D. Rackham, Georgia Antoniou, Andrew P. Oakley, Brian J. C. Freeman, Leanne M. Sutherland and Peter J. Cundy
Abstract: Study Design. Case–control study. Objective. To determine whether serum metal ion levels and erythrocyte chromium levels in adolescents with stainless steel spinal instrumentation are elevated when compared with 2 control groups. Summary of Background Data. Instrumented spinal arthrodesis is a common procedure to correct scoliosis. The long-term consequences of retained implants are unclear. Possible toxic effects related to raised metal ion levels have been reported in the literature. Methods. Thirty patients who underwent posterior spinal arthrodesis with stainless steel instrumentation for scoliosis (group 1) were included. Minimum postoperative duration was 3 years. Serum chromium, molybdenum, iron, and ferritin levels were measured. Participants with elevated above normal serum chromium levels (n = 11) also underwent erythrocyte chromium analysis. Comparisons were made with 2 control groups; 10 individuals with scoliosis with no spinal surgery (group 2) and 10 volunteers without scoliosis (group 3). All control group participants underwent serum and erythrocyte analysis. Results. Elevated above normal serum chromium levels were demonstrated in 11 of 30 (37%) group 1 participants. Elevated serum chromium levels were demonstrated in 0 of 10 participants (0%) in group 2 and 1 of 10 (10%) in group 3. There was a statistically significant elevation in serum chromium levels between group 1 and group 2 participants (P = 0.001). There was no significant association between groups 1, 2, and 3 for serum molybdenum, iron, and ferritin levels. Erythrocyte chromium measurements were considered within the normal range for all participants tested (n = 31). Conclusion. Raised serum chromium levels were detected in 37% of patients following instrumented spinal arthrodesis for correction of scoliosis. This new finding has relatively unknown health implications but potential mutagenic, teratogenic and carcinogenic sequelae. This is especially concerning with most scoliosis patients being adolescent females with their reproductive years ahead.
Keywords: scoliosis; surgery; arthrodesis; posterior; instrumentation; chromium; metal ion; corrosion
Rights: © 2010 Lippincott Williams & Wilkins, Inc.
RMID: 0020097238
DOI: 10.1097/BRS.0b013e3181d53724
Appears in Collections:Paediatrics publications

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.