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Related Experiment Video

Updated: Jun 13, 2026

Multi-Scale Modification of Metallic Implants With Pore Gradients, Polyelectrolytes and Their Indirect Monitoring In vivo
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Published on: July 1, 2013

Electron Microprobe Analysis and Tissue Reaction around Titanium Alloy Spinal Implants.

Hee-Dong Kim1, Ki-Soo Kim, Sung-Chan Ki

  • 1Department of Orthopedic Surgery, Kwangju Christian Hospital, Gwangju, Korea.

Asian Spine Journal
|April 23, 2010
PubMed
Summary

Metal debris from spinal implants can cause inflammation and pain. Histological analysis revealed titanium particles and macrophage responses in surrounding tissues, potentially explaining late-onset pain after surgery.

Keywords:
Metallic debrisPosterior pedicular instrumentationsTissue reactionTitanium alloy

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Last Updated: Jun 13, 2026

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Area of Science:

  • Spinal surgery
  • Biomaterials science
  • Orthopedic research

Background:

  • Microscopic metal particles from joint implants can trigger macrophage responses, leading to bone resorption and inflammation.
  • The clinical impact of wear particles from spinal instrumentation is a significant concern.

Purpose of the Study:

  • To identify metal debris generated by spinal implants.
  • To evaluate electron microprobe analysis findings and the histological response of periprosthetic soft tissues.

Main Methods:

  • Retrospective study of periprosthetic tissues from ten patients undergoing revision surgery after lumbar fusion with pedicle screw instrumentation.
  • Histological, immunohistochemical, and scanning electron microscopy analyses were performed on explanted tissues.
  • Assessment of back pain and spinal fusion status post-implant removal.

Main Results:

  • Metal particles were detected in the soft tissues of 7 out of 10 patients.
  • Mild chronic inflammation and macrophage (anti-Cotrel-Dubousset 68 positive) presence were observed adjacent to metal particles in 5 patients.
  • Scanning electron microscopy confirmed metallic debris, with titanium distribution mapped in 5 cases. Nine patients experienced back pain relief post-explantation.

Conclusions:

  • The presence of metallic particles from spinal implants may initiate late-onset inflammatory responses.
  • These particles and associated inflammatory reactions could contribute to late operative site pain.