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Hypersensitivity reactions to metals in spine surgery
S Dadkhahfar1, M Chehrassan2, C Faldini3
1Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Musculoskeletal Surgery
|November 7, 2022
Summary
Hypersensitivity to spinal implants is rare but underdiagnosed. This review focuses on skin reactions occurring weeks to months after spinal instrumentation, highlighting the need for better diagnostic guidelines.
Area of Science:
- Orthopedic Surgery
- Dermatology
- Materials Science
Background:
- Hypersensitivity to orthopedic devices is uncommon, with few reported cases following spinal instrumentation.
- Spinal fusion utilizes various metallic implants, distinct from those in joint arthroplasty.
- Reactions typically manifest weeks to months post-implantation.
Purpose of the Study:
- To review reported hypersensitivity reactions to spinal implants.
- To focus on the cutaneous presentations of these reactions.
- To underscore the underdiagnosis of hypersensitivity to spinal devices.
Main Methods:
- Literature review of hypersensitivity reactions post-spinal surgery.
- Analysis of case reports focusing on metallic spinal instrumentation.
- Categorization of cutaneous manifestations.
Main Results:
- Hypersensitivity reactions after spinal instrumentation are rare but documented.
- Cutaneous presentations are a key feature of these reactions.
- Delayed onset (weeks to months) is characteristic.
Conclusions:
- Hypersensitivity to spinal implants, particularly metal, can cause dermatological issues.
- Lack of diagnostic criteria contributes to underestimation of incidence.
- Further research is needed to establish diagnostic guidelines for implant hypersensitivity.
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