Shang Xianping, Wang Ling, Kou Depeng, Jia Xunyuan, Yang Xianglong, Zhang Meng, Tang Yilong, Wang Pengrui, Wang Shijin, Xu Yan, Wang Hong
Department of Spine Surgery, First Affiliated Hospital of Dalian Medical University, Dalian 116011, People's Republic of China.
BMC Musculoskelet Disord. 2014 Sep 26;15:314. doi: 10.1186/1471-2474-15-314.
Metal hypersensitivity, mostly documented in prosthesis implantation, is a rare complication after arthroplasty. Such cases become rarer and more difficult to diagnose when it comes to lumbar surgery.
We present the case of a 52-year-old female patient with reoccured low back pain and sciatica after posterior lumbar decompression and fusion (PLDF) for her lumbar disc herniation. The initial clinical and radiological examinations showed no pathologies. Further imaging and histopathological studies in later period revealed an aseptic loosening of the hardware and an aseptic inflammatory response which was diagnosed to be metal hypersensitivity. To our knowledge, few allergic cases in the matter of spinal fusion were reported so far.
Metal hypersensitivity after spinal fusion should be considered in patients with representation of postoperative back pain. And elaborate history taking would conduce a lot to it's diagnose.
金属超敏反应在假体植入中多有记载，是关节置换术后一种罕见的并发症。在腰椎手术中，此类病例更为罕见且诊断难度更大。
我们报告一例52岁女性患者，因腰椎间盘突出症接受后路腰椎减压融合术（PLDF）后，反复出现腰痛和坐骨神经痛。最初的临床和影像学检查未发现病变。后期进一步的影像学和组织病理学研究显示内固定装置无菌性松动及无菌性炎症反应，诊断为金属超敏反应。据我们所知，迄今为止，脊柱融合方面的过敏病例报道较少。
对于术后出现背痛的患者，应考虑脊柱融合术后发生金属超敏反应的可能性。详尽的病史采集对其诊断有很大帮助。
