STUDY DESIGN: Cross-sectional study of 10 patients to measure the serum levels of cobalt and chromium after TDA. OBJECTIVES: To investigate the release of cobalt and chromium ions into the serum following implantation of the metal-on-metal Maverick-type artificial lumbar disc. SUMMARY OF BACKGROUND DATA: In total hip endoprosthetics and consequently for TDA (total disc arthroplasty), metal-on-metal combinations are used with the aim of reducing wear debris. In metal-on-metal TDA the release of metal ions has until now been secondary to the main discussion. MATERIALS AND METHODS: We investigated the serum cobalt and chromium concentration following implantation of 15 Maverick TDAs (monosegmental L5-S1, n = 5; bisegmental L4-L5 and L5-S1, n = 5; average age, 36.5 years). Five healthy subjects (no metal implants) acted as a control group. The measurements of the metals were carried out using the HITACHI Z-8200 AAS polarized Zeeman atomic absorption spectrometer after an average of 14.8 months. RESULTS: The concentrations of cobalt and chromium ions in the serum amounted on average to 4.75 microg/L (SD, 2.71) for cobalt and 1.10 microg/L (SD, 1.24) for chromium. Compared with control group, both the chromium and cobalt levels in the serum showed significant increases (Mann-Whitney U test, P = 0.0120). At follow-up,the Oswestry Disability Score was on average significantly decreased by 24.4 points (L5-S1) (t test, P < 0.05) and by 26.8 points (L4-S1) (t test, P < 0.05). The improved clinical situation is also represented by a significant decrease of the Visual Analog Pain Scale of 42.2 points after the follow-up (t test, P < 0.05). CONCLUSION: Significant systemic release of Cr/Co was proven in the serum compared with the control group. The concentrations of Cr/Co measured in the serum are similar in terms of their level to the values measured in THA metal-on-metal combinations or exceed these values given in the literature. Long-term implication of this metal exposure is unknown and should be studied further.
STUDY DESIGN: Cross-sectional study of 10 patients to measure the serum levels of cobalt and chromium after TDA. OBJECTIVES: To investigate the release of cobalt and chromium ions into the serum following implantation of the metal-on-metal Maverick-type artificial lumbar disc. SUMMARY OF BACKGROUND DATA: In total hip endoprosthetics and consequently for TDA (total disc arthroplasty), metal-on-metal combinations are used with the aim of reducing wear debris. In metal-on-metal TDA the release of metal ions has until now been secondary to the main discussion. MATERIALS AND METHODS: We investigated the serum cobalt and chromium concentration following implantation of 15 Maverick TDAs (monosegmental L5-S1, n = 5; bisegmental L4-L5 and L5-S1, n = 5; average age, 36.5 years). Five healthy subjects (no metal implants) acted as a control group. The measurements of the metals were carried out using the HITACHI Z-8200 AAS polarized Zeeman atomic absorption spectrometer after an average of 14.8 months. RESULTS: The concentrations of cobalt and chromium ions in the serum amounted on average to 4.75 microg/L (SD, 2.71) for cobalt and 1.10 microg/L (SD, 1.24) for chromium. Compared with control group, both the chromium and cobalt levels in the serum showed significant increases (Mann-Whitney U test, P = 0.0120). At follow-up,the Oswestry Disability Score was on average significantly decreased by 24.4 points (L5-S1) (t test, P < 0.05) and by 26.8 points (L4-S1) (t test, P < 0.05). The improved clinical situation is also represented by a significant decrease of the Visual Analog Pain Scale of 42.2 points after the follow-up (t test, P < 0.05). CONCLUSION: Significant systemic release of Cr/Co was proven in the serum compared with the control group. The concentrations of Cr/Co measured in the serum are similar in terms of their level to the values measured in THA metal-on-metal combinations or exceed these values given in the literature. Long-term implication of this metal exposure is unknown and should be studied further.
Authors: Christoph J Siepe; Franziska Heider; Elisabeth Haas; Wolfgang Hitzl; Ulrike Szeimies; Axel Stäbler; Christoph Weiler; Andreas G Nerlich; Michael H Mayer Journal: Eur Spine J Date: 2012-05-29 Impact factor: 3.134
Authors: Sai Y Veruva; Marla J Steinbeck; Jeffrey Toth; Dominik D Alexander; Steven M Kurtz Journal: Clin Orthop Relat Res Date: 2014-12 Impact factor: 4.176
Authors: Thomas M Grupp; James J Yue; Rolando Garcia; Christian Kaddick; Bernhard Fritz; Christoph Schilling; Jens Schwiesau; Wilhelm Blömer Journal: Eur Spine J Date: 2014-06-06 Impact factor: 3.134
Authors: Ilona M Punt; Shennah Austen; Jack P M Cleutjens; Steven M Kurtz; René H M ten Broeke; Lodewijk W van Rhijn; Paul C Willems; André van Ooij Journal: Spine (Phila Pa 1976) Date: 2012-01-15 Impact factor: 3.468