Blood cobalt levels elevated with rod fracture following posterior spinal fusion in scoliosis: A report of two cases

JOS Case Reports Pub Date : 2023-09-01 DOI:10.1016/j.joscr.2023.05.002

Shota Tamagawa , Tatsuya Sato , Hidetoshi Nojiri , Takehisa Matsukawa , Takahiro Ushimaki , Kentaro Ishii , Seiya Ishii , Yasuhiro Homma , Muneaki Ishijima

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Abstract

Background

Elevated blood metal ion levels and the accumulation of metal debris in peri-implant tissues have been reported after metal-on-metal total hip arthroplasty and total disc replacement. However, little is known about the relationship between blood metal ion levels and clinical adverse events in instrumented spinal fusion surgery.

Case presentation

We report 2 cases of scoliosis with elevated blood cobalt levels following cobalt-chromium rod fracture. Following fractured rod removal and rod replacement, the blood cobalt levels decreased over time. At the final follow-up, both patients presented without symptoms, correction loss, or rod fractures on radiographs.

Conclusions

Our results suggest that repeated macro-motion may result in metal ion release due to mechanical wear and corrosion of the fracture surfaces. In patients with rod fracture, it may be worthwhile to measure blood cobalt levels and consider revision surgery if necessary.

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脊柱侧弯后路融合术后棒状骨折血钴水平升高（附2例报告）

背景据报道，金属对金属全髋关节置换术和椎间盘置换术后，血液金属离子水平升高，植入物周围组织中金属碎片堆积。然而，在器械脊柱融合手术中，血液金属离子水平与临床不良事件之间的关系知之甚少。病例介绍：我们报告2例钴铬棒骨折后血钴水平升高的脊柱侧弯。在取出骨折的棒和更换棒后，血液中的钴水平随着时间的推移而下降。在最后的随访中，两名患者在射线照片上均无症状、矫正损失或杆骨折。结论我们的研究结果表明，重复的宏观运动可能导致骨折表面的机械磨损和腐蚀导致金属离子释放。对于杆骨折患者，可能值得测量血液中的钴水平，并在必要时考虑翻修手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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JOS Case Reports

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