Caglar Yilgor1, Ayaz Efendiyev2, Filiz Akbiyik3, Gokhan Demirkiran2, Alpaslan Senkoylu4, Ahmet Alanay1, Muharrem Yazici5. 1. Orthopedics and Traumatology, Acibadem Mehmet Ali Aydınlar University, İçerenköy Mh. No:32 Kerem Aydınlar Kampüsü, Kayışdağı Cd., 34752 Ataşehir, Turkey. 2. Orthopedics and Traumatology, Hacettepe University, 06100 Sihhiye, Ankara, Turkey. 3. Medical Biochemistry, Hacettepe University, 06100 Sihhiye, Ankara, Turkey. 4. Orthopedics and Traumatology, Gazi University, Emniyet Mahallesi, 06560 Yenimahalle, Ankara, Turkey. 5. Orthopedics and Traumatology, Hacettepe University, 06100 Sihhiye, Ankara, Turkey. Electronic address: mimyazici@gmail.com.
Abstract
BACKGROUND: Metal ions released from spinal instruments can cause localized debris and distribute systemically to settle on distant organs. Children with early-onset deformities live with metallic implants for a substantial amount of time. No research focused on metal distribution in growth-friendly instrumentations. The aim of this study was to compare age-matched growing rod (GR) and magnetically controlled growing rod (MCGR) groups to noninstrumented controls. METHODS: The study was designed as a multicenter, prospective, cross-sectional case series. GR and MCGR applications of three institutions were included. A total of 52 children were enrolled. Blood samples were collected between December 2014 and February 2015. Biochemical serum analyses were performed to trace and quantify titanium, vanadium, aluminum, and boron. The GR group included 15 children. Mean age was 10.7 (range 6-15). MCGR group included 22 children. Mean age was 8.5 (range 2-13). Fifteen age-matched nonoperated children formed the control group. The mean age was 10.4 (range 5-15). One-way analysis of variance, Kruskal-Wallis, and Mann-Whitney U tests were used for comparisons. RESULTS: The mean serum titanium level in control, GR, and MCGR groups were 2.8 ± 1.4, 7.3 ± 4.3, and 10.2 ± 6.8 μg/L, respectively. GR and MCGR group titanium levels were higher than controls' (p = .008 and p < .001). The mean serum vanadium level in control, GR, and MCGR groups were 0.2 ± 0.0, 0.2 ± 0.0, and 0.5 ± 0.5 μg/L, respectively. MCGR group vanadium level was higher than control (p < .001) and GR groups (p = .004). Mean serum levels in control, GR, and MCGR groups were, respectively, 5.4 ± 4.1, 8.1 ± 7.4, and 7.8 ± 5.1 μg/L for aluminum and 86.7 ± 2.7, 86.9 ± 2.5, and 85.0 ± 6.6 μg/L for boron. The distribution of aluminum and boron were similar across groups (p = .675 and p = .396). CONCLUSIONS: Both GR and MCGR applications significantly release titanium and possibly aluminum. MCGR further releases vanadium. MCGR possibly releases more titanium than traditional GR. Time-dependent alterations of serum ion levels, structural properties of the MCGR device, and exposure caused by magnetic distraction processes warrant investigation.
BACKGROUND:Metal ions released from spinal instruments can cause localized debris and distribute systemically to settle on distant organs. Children with early-onset deformities live with metallic implants for a substantial amount of time. No research focused on metal distribution in growth-friendly instrumentations. The aim of this study was to compare age-matched growing rod (GR) and magnetically controlled growing rod (MCGR) groups to noninstrumented controls. METHODS: The study was designed as a multicenter, prospective, cross-sectional case series. GR and MCGR applications of three institutions were included. A total of 52 children were enrolled. Blood samples were collected between December 2014 and February 2015. Biochemical serum analyses were performed to trace and quantify titanium, vanadium, aluminum, and boron. The GR group included 15 children. Mean age was 10.7 (range 6-15). MCGR group included 22 children. Mean age was 8.5 (range 2-13). Fifteen age-matched nonoperated children formed the control group. The mean age was 10.4 (range 5-15). One-way analysis of variance, Kruskal-Wallis, and Mann-Whitney U tests were used for comparisons. RESULTS: The mean serum titanium level in control, GR, and MCGR groups were 2.8 ± 1.4, 7.3 ± 4.3, and 10.2 ± 6.8 μg/L, respectively. GR and MCGR group titanium levels were higher than controls' (p = .008 and p < .001). The mean serum vanadium level in control, GR, and MCGR groups were 0.2 ± 0.0, 0.2 ± 0.0, and 0.5 ± 0.5 μg/L, respectively. MCGR group vanadium level was higher than control (p < .001) and GR groups (p = .004). Mean serum levels in control, GR, and MCGR groups were, respectively, 5.4 ± 4.1, 8.1 ± 7.4, and 7.8 ± 5.1 μg/L for aluminum and 86.7 ± 2.7, 86.9 ± 2.5, and 85.0 ± 6.6 μg/L for boron. The distribution of aluminum and boron were similar across groups (p = .675 and p = .396). CONCLUSIONS: Both GR and MCGR applications significantly release titanium and possibly aluminum. MCGR further releases vanadium. MCGR possibly releases more titanium than traditional GR. Time-dependent alterations of serum ion levels, structural properties of the MCGR device, and exposure caused by magnetic distraction processes warrant investigation.
Authors: Martina Tognini; Harry Hothi; Elisabetta Dal Gal; Masood Shafafy; Colin Nnadi; Stewart Tucker; Johann Henckel; Alister Hart Journal: Eur Spine J Date: 2021-03-05 Impact factor: 3.134
Authors: K A Lüders; L Braunschweig; A Zioła-Frankowska; A Stojek; D Jakkielska; A Wichmann; G H Dihazi; F Streit; S E Güsewell; T C Trüe; S Lüders; J Schlie; K Tsaknakis; H M Lorenz; M Frankowski; A K Hell Journal: Sci Rep Date: 2022-06-25 Impact factor: 4.996
Authors: Martina Tognini; Harry Hothi; Stewart Tucker; Edel Broomfield; Masood Shafafy; Panos Gikas; Anna Di Laura; Johann Henckel; Alister Hart Journal: BMC Musculoskelet Disord Date: 2022-08-16 Impact factor: 2.562
Authors: Jack Z Wei; Harry S Hothi; Holly Morganti; Sean Bergiers; Elisabetta Dal Gal; Doris Likcani; Johann Henckel; Alister J Hart Journal: BMC Musculoskelet Disord Date: 2020-08-05 Impact factor: 2.362