Kirkpatrick John S, Venugopalan Ramakrishna, Beck Preston, Lemons Jack
Division of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
J Spinal Disord Tech. 2005 Jun;18(3):247-51.
Modular spine implants are used as an aid to obtaining fusion, but fretting and corrosion occur between modular components in a biologic environment.
Forty-eight spinal implant constructs manufactured by a variety of companies were retrieved from 47 patients and were subjected to surface analysis stereomicroscopy.
Stainless-steel implants (n = 23) had either semirigid constructs with mild or no surface alteration (n = 7) or rigid constructs with moderate or severe alteration (n = 16). Surface damage was consistent with previously observed mechanically assisted crevice corrosion phenomena. Titanium alloy implants (n = 25) showed no significant corrosion but had three constructs with fatigue failure of anchoring screws. One cobalt alloy construct showed no evidence of corrosion.
Long-term effects of fretting and corrosion are unclear, and minimization of these phenomena seems justified. Selection of modular components with similar materials and surface finish may help the surgeon minimize localized changes over time. Stainless-steel implants with rigid interconnections and those with different surface finishes between rods and connectors are most susceptible to corrosion.
模块化脊柱植入物用于辅助实现融合,但在生物环境中,模块化部件之间会出现微动磨损和腐蚀。
从47例患者中取出由多家公司制造的48个脊柱植入物构建体,并对其进行表面分析立体显微镜检查。
不锈钢植入物(n = 23)中,有半刚性构建体表面轻度改变或无改变(n = 7),或刚性构建体表面中度或重度改变(n = 16)。表面损伤与先前观察到的机械辅助缝隙腐蚀现象一致。钛合金植入物(n = 25)未显示明显腐蚀,但有3个构建体的锚固螺钉出现疲劳失效。1个钴合金构建体未显示腐蚀迹象。
微动磨损和腐蚀的长期影响尚不清楚,尽量减少这些现象似乎是合理的。选择材料和表面光洁度相似的模块化部件可能有助于外科医生减少随时间推移的局部变化。具有刚性互连的不锈钢植入物以及杆与连接器之间表面光洁度不同的植入物最易受到腐蚀。