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Metal debris from titanium spinal implants.

J C Wang¹, W D Yu, H S Sandhu

¹Department of Orthopaedic Surgery, School of Medicine, University of California, Los Angeles, USA. jwang@mednet.ucla.edu

|May 18, 1999

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Titanium spinal instrumentation generates wear debris, particularly in patients with pseudarthrosis. This metal particle accumulation triggers a macrophage response in spinal tissues, unlike solid fusions where levels are negligible.

Area of Science:

Spine surgery
Biomaterials
Orthopedic research

Background:

Microscopic metal particles from joint arthroplasties can cause inflammation and bone resorption.
Titanium spinal implants may generate similar wear debris in spinal tissues.

Purpose of the Study:

Quantify metal debris from titanium pedicle screw instrumentation.
Evaluate the histologic response to this debris in spinal tissues.

Main Methods:

Prospective study of 9 patients undergoing reoperation for spinal instrumentation.
Histologic and chemical analysis of tissue samples near instrumentation.
Titanium levels measured by electrothermal atomic absorption spectroscopy.
Microscopic analysis using light and electron microscopy.

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Main Results:

Elevated titanium concentrations (30.36 µg/g) found in patients with pseudarthrosis.
Negligible titanium levels (0.586 µg/g) in patients with solid fusion.
Metal particles and macrophage activation observed in soft tissues via microscopy.

Conclusions:

Titanium spinal instrumentation generates wear debris in cases of pseudarthrosis.
This debris elicits a macrophage response in spinal tissues.
Solid spinal fusion is associated with minimal particulate matter.