Corrosion of the Harrington's instrumentation and biological behaviour of the rod-human spine system

Aulisa, Lorenzo; Benedetto, Adriana Di; Vinciguerra, A.; Lorini, Giuseppe; Tranquilli-Leali, P.

doi:10.1016/0142-9612(82)90028-x

Cited by 32 publications

(18 citation statements)

References 2 publications

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“…Corrosion has been observed in most types of spinal instrumentations used in the last 40 years, including Harrington, Isola, TSRH, CD and others [1,2,8,25,27,29]. In general, production of particulate debris has been associated with modularity of implants [18].…”

Section: Discussionmentioning

confidence: 99%

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Metal levels in corrosion of spinal implants

Rı́o¹,

Beguiristáin²,

Duart³

2007

Eur Spine J

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Corrosion affects spinal instrumentations and may cause local and systemic complications. Diagnosis of corrosion is difficult, and nowadays it is performed almost exclusively by the examination of retrieved instrumentations. We conducted this study to determine whether it is possible to detect corrosion by measuring metal levels on patients with posterior instrumented spinal fusion. Eleven asymptomatic patients, with radiological signs of corrosion of their stainless steel spinal instrumentations, were studied by performing determinations of nickel and chromium in serum and urine. Those levels were compared with the levels of 22 patients with the same kind of instrumentation but without evidence of corrosion and to a control group of 22 volunteers without any metallic implants. Statistical analysis of our results revealed that the patients with spinal implants without radiological signs of corrosion have increased levels of chromium in serum and urine (P < 0.001) compared to volunteers without implants. Corrosion significantly raised metal levels, including nickel and chromium in serum and urine when compared to patients with no radiological signs of corrosion and to volunteers without metallic implants (P < 0.001). Metal levels measured in serum have high sensibility and specificity (area under the ROC curve of 0.981). By combining the levels of nickel and chromium in serum we were able to identify all the cases of corrosion in our series of patients. The results of our study confirm that metal levels in serum and urine are useful in the diagnosis of corrosion of spinal implants and may be helpful in defining the role of corrosion in recently described clinical entities such as late operative site pain or late infection of spinal implants.

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Section: Discussionmentioning

confidence: 99%

“…In fact, Aulisa et al [2] published, in 1982, a case of corrosion in Harrington instrumentation. Modern spinal instrumentations also suffer corrosion.…”

Section: Introductionmentioning

confidence: 99%

Metal levels in corrosion of spinal implants

Rı́o¹,

Beguiristáin²,

Duart³

2007

Eur Spine J

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“…The junction between the rod and the anchoring system in spinal devices may cause a local mechanical breakdown of the protective surface layer. Especially in the case of pseudoarthrosis, cyclic movements at the non-fused level may initiate corrosion and fretting processes, which may cause an increase in the passive ion release or a release of particulate wear debris [3,9,35,36]. Local tattooing of the surrounding soft tissue by wear debris and the accumulation of gray, brown or black serosanguineous fluid are typical signs of these wear processes.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, it is well known that spinal implants are prone to corrosion due to their construction. In particular, the junction between pedicle screw, hooks and sublaminar wires to the rod might lead to biocompatibility problems [3,9,35,36]. Therefore, new spinal implants should be examined in vivo to ascertain whether corrosion and a reaction in adjacent tissue occur.…”

Section: Introductionmentioning

confidence: 99%

Scoliosis correction with shape-memory metal: results of an experimental study

et al. 2001

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IntroductionOperations for scoliosis are designed to correct the deformity and to prevent its progression by achieving a solid fusion. In 1962, Harrington introduced the use of spinal instrumentation for the surgical treatment of scoliosis [16]. In the 1980s, the development of spinal instrumentation expanded considerably. New anterior and posterior systems were introduced [2,6,10,12,18,32]. With these advanced segmental systems, better corrections are possible in the coronal and the sagittal plain in comparison with Harrington instrumentation. However, the literature is contradictory on the effect on axial rotation and rib cage deformity. In most literature it is suggested that axial plane correction is limited [13,19,21,33].Abstract The biocompatibility and functionality of a new scoliosis correction device, based on the properties of the shape-memory metal nickel-titanium alloy, were studied. With this device, the shape recovery forces of a shape-memory metal rod are used to achieve a gradual threedimensional scoliosis correction. In the experimental study the action of the new device was inverted: the device was used to induce a scoliotic curve instead of correcting one. Surgical procedures were performed in six pigs. An originally curved squared rod, in the cold condition, was straightened and fixed to the spine with pedicle screws. Peroperatively, the memory effect of the rod was activated by heating the rod to 50°C by a low-voltage, high-frequency current. After 3 and after 6 months the animals were sacrificed. The first radiographs, obtained immediately after surgery, showed in all animals an induced curve of about 40°Cobb angle -the original curve of the rod. This curve remained constant during the followup. The postoperative serum nickel measurements were around the detection limit, and were not significantly higher compared to the preoperative nickel concentration. Macroscopic inspection after 3 and 6 months showed that the device was almost overgrown with newly formed bone. Corrosion and fretting processes were not observed. Histologic examination of the sections of the surrounding tissues and sections of the lung, liver, spleen and kidney showed no evidence of a foreign body response. In view of the initiation of the scoliotic deformation, it is expected that the shape-memory metal based scoliosis correction device also has the capacity to correct a scoliotic curve. Moreover, it is expected that the new device will show good biocompatibility in clinical application. Extensive fatigue testing of the whole system should be performed before clinical trials are initiated.

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“…10 Few reports of significant implant failure rate of 31% and pseudarthrosis rate of 23% in anterior only correction. To best of the knowledge none of the studies till date has mentioned the incidence of screw pull out in anterior scoliosis surgery.…”

Section: Evolution Of Anterior Spinal Instrumentationmentioning

confidence: 99%

Anterior scoliosis surgery the state of art procedure

Gopinathan¹

2015

Journal of Orthopaedics

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Corrosion of the Harrington's instrumentation and biological behaviour of the rod-human spine system

Cited by 32 publications

References 2 publications

Metal levels in corrosion of spinal implants

Metal levels in corrosion of spinal implants

Scoliosis correction with shape-memory metal: results of an experimental study

Anterior scoliosis surgery the state of art procedure

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