Goldenberg Yoni, Tee Jin W, Salinas-La Rosa Cesar M, Murphy Michael
Department of Neurosurgery and Neurosciences, St Vincent's Hospital, Level 10 IPS Building, 59 Victoria Parade, Fitzroy, Melbourne, VIC, 3065, Australia.
Department of Anatomical Pathology, St Vincent's Hospital, Melbourne, VIC, Australia.
Eur Spine J. 2016 May;25(5):1467-1473. doi: 10.1007/s00586-015-4347-6. Epub 2016 Jan 5.
To document a rarely reported complication associated with spinal instrumentation and to evaluate the current literature on spinal metallosis and spinal metalloma.
A local case report is presented. EBSCOhost, PubMed and ScienceDirect databases were used to conduct a systematic review for articles describing spinal metallosis and spinal metalloma.
A total of 836 articles were identified using the terms "metalloma" or "metallosis". Exclusion of arthroplasty-related abstracts retrieved 46 articles of which 3 full text articles presenting spinal metalloma as a causative pathological finding responsible for neurological signs and symptoms in patients with previous spinal fusion instrumentation were reviewed. Our case is the first described with titanium-composed posterior instrumentation and fifth reported, demonstrating the phenomena of neurological symptoms and signs attributed directly to neural tissue compression by spinal metalloma after spinal instrumentation.
Spinal metallosis can present weeks to years after spinal instrumentation surgery and is a potential cause of neural compression. This process appears to be independent of the instrument composition as metallosis has now been demonstrated in both titanium and stainless steel constructs.
记录一种与脊柱内固定相关的罕见并发症，并评估当前关于脊柱金属沉着症和脊柱金属瘤的文献。
呈现一例本地病例报告。使用EBSCOhost、PubMed和ScienceDirect数据库对描述脊柱金属沉着症和脊柱金属瘤的文章进行系统综述。
使用“金属瘤”或“金属沉着症”检索到共836篇文章。排除与关节置换相关的摘要后获得46篇文章，其中3篇全文文章将脊柱金属瘤作为导致先前脊柱融合内固定患者出现神经症状和体征的致病病理发现进行了综述。我们的病例是首例报道的钛合金后路内固定病例，也是第五例报道，证实了脊柱内固定术后脊柱金属瘤直接压迫神经组织导致神经症状和体征的现象。
脊柱金属沉着症可在脊柱内固定手术后数周或数年出现，是神经受压的潜在原因。这一过程似乎与器械成分无关，因为现在已在钛合金和不锈钢植入物中均证实了金属沉着症。
