前瞻性研究金属对金属腰椎间盘置换术后患者血清金属水平。
Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty.
机构信息
Spine Research Center, The Orthopedic Center of St. Louis, 14825 North Outer Forty Road, Suite 320, St. Louis, MO 63017, USA.
出版信息
Eur Spine J. 2013 Apr;22(4):741-6. doi: 10.1007/s00586-012-2581-8. Epub 2012 Nov 20.
PURPOSE
Metal-on-metal total disc replacement is a recent alternative treatment for degenerative disc disease. Wear and corrosion of these implants can lead to local and systemic transport of metal debris. This prospective longitudinal study examined the serum chromium and cobalt levels in 24 patients with cobalt-chromium alloy metal-on-metal lumbar disc replacements.
METHODS
Serum was assayed for chromium (Cr) and cobalt (Co) using high-resolution inductively-coupled plasma-mass spectrometry. Detection limits were 0.015 ng/mL for Cr and 0.04 ng/mL for Co.
RESULTS
Median serum Co levels at pre-op, 3, 6, 12, 24, and 36-months post-op were 0.10, 1.03, 0.96, 0.98, 0.67, and 0.52 ng/mL, respectively. Median serum Cr levels were 0.06, 0.49, 0.65, 0.43, 0.52, and 0.50 ng/mL, respectively.
CONCLUSION
In general, these results indicated that serum Co and Cr levels are elevated at all postoperative time points and are of the same order of magnitude as those observed in well-functioning metal-on-metal surface replacements of the hip and in metal-on-metal total hip replacements at similar postoperative time points.
目的
金属对金属全椎间盘置换术是一种治疗退行性椎间盘疾病的新方法。这些植入物的磨损和腐蚀会导致金属碎片的局部和全身迁移。本前瞻性纵向研究检测了 24 例钴铬合金金属对金属腰椎间盘置换患者的血清铬和钴水平。
方法
使用高分辨率电感耦合等离子体质谱法检测血清中的铬（Cr）和钴（Co）。Cr 的检测限为 0.015ng/ml，Co 的检测限为 0.04ng/ml。
结果
术前、术后 3、6、12、24 和 36 个月的血清 Co 中位数水平分别为 0.10、1.03、0.96、0.98、0.67 和 0.52ng/ml。血清 Cr 中位数水平分别为 0.06、0.49、0.65、0.43、0.52 和 0.50ng/ml。
结论
总的来说，这些结果表明，术后所有时间点的血清 Co 和 Cr 水平均升高，且与髋关节金属对金属表面置换和类似术后时间点的金属对金属全髋关节置换中观察到的水平相当。
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