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Serum titanium levels after instrumented spinal arthrodesis.
Travis D Richardson1, Stephen J Pineda, K Brandon Strenge
1Division of Orthopaedics and Rehabilitation, Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9679, USA.
Spine
|April 2, 2008
Summary
Patients with titanium spinal implants show higher serum titanium levels compared to controls. Titanium interbody devices may contribute to increased ion levels, warranting further investigation into spinal instrumentation characteristics.
Area of Science:
- Orthopedics
- Biomaterials Science
- Neurosurgery
Background:
- Previous research indicates localized titanium debris around spinal instrumentation.
- Systemic distribution of metal debris is evidenced by elevated serum ion levels in patients with titanium spinal implants.
Purpose of the Study:
- To quantify serum titanium levels in patients post-instrumented spinal arthrodesis.
- To identify factors related to instrumentation characteristics that influence serum ion levels.
Main Methods:
- Retrospective study of 30 patients with titanium alloy spinal instrumentation.
- Measurement of postoperative serum titanium concentrations.
- Comparison with a control group and analysis of instrumentation variables (screws, connectors, interbody devices).
Main Results:
- Serum titanium levels were significantly higher in patients with titanium implants (2.6 microg/L) versus controls (0.71 microg/L).
- Patients with titanium interbody devices showed significantly elevated serum titanium levels (3.3 microg/L) compared to those without (1.98 microg/L).
- Trends suggested higher levels with more spinal segments fused or more pedicle screws, but these were not statistically significant.
Conclusions:
- Significantly elevated serum titanium concentrations are present in patients with titanium spinal instrumentation.
- Further research is needed to understand the impact of titanium interbody devices and cross connectors on serum ion levels.