Chromium ion release from stainless steel pediatric scoliosis instrumentation

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dc.contributor.authorCundy, T.
dc.contributor.authorDelaney, C.
dc.contributor.authorRackham, M.
dc.contributor.authorAntoniou, G.
dc.contributor.authorOakley, A.
dc.contributor.authorFreeman, B.
dc.contributor.authorSutherland, L.
dc.contributor.authorCundy, P.
dc.date.issued2010
dc.description.abstractStudy 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.
dc.description.statementofresponsibilityThomas P. Cundy, Christopher L. Delaney, Matthew D. Rackham, Georgia Antoniou, Andrew P. Oakley, Brian J. C. Freeman, Leanne M. Sutherland and Peter J. Cundy
dc.identifier.citationSpine, 2010; 35(9):967-974
dc.identifier.doi10.1097/BRS.0b013e3181d53724
dc.identifier.issn0362-2436
dc.identifier.issn1528-1159
dc.identifier.orcidCundy, T. [0000-0002-3884-2567]
dc.identifier.orcidFreeman, B. [0000-0003-0237-9707]
dc.identifier.orcidSutherland, L. [0000-0002-7822-3189]
dc.identifier.orcidCundy, P. [0000-0002-8050-6153]
dc.identifier.urihttp://hdl.handle.net/2440/61676
dc.language.isoen
dc.publisherLippincott Williams & Wilkins
dc.rights© 2010 Lippincott Williams & Wilkins, Inc.
dc.source.urihttps://doi.org/10.1097/brs.0b013e3181d53724
dc.subjectscoliosis
dc.subjectsurgery
dc.subjectarthrodesis
dc.subjectposterior
dc.subjectinstrumentation
dc.subjectchromium
dc.subjectmetal ion
dc.subjectcorrosion
dc.titleChromium ion release from stainless steel pediatric scoliosis instrumentation
dc.typeJournal article
pubs.publication-statusPublished

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