Department of Spine Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Spine Surgery, The First Affiliated Hospital of Dali University, Yunnan, China.
Br J Neurosurg. 2023 Aug;37(4):916-920. doi: 10.1080/02688697.2020.1718605. Epub 2020 Jan 31.
Cases of allergy to large surgical implants have been reported. However, few studies have reported allergy to small titanium-containing implants (e.g. Zero-P device).
We reported the case of a 51-year old male patient who underwent the anterior cervical discectomy and fusion (ACDF) procedure using a Zero-P device and exhibited allergic symptoms 1 month after the surgery.
The allergic symptoms included intermittent tingling and itches in the throat induced by speaking. Systemic rashes over the skin surface and congestion of the eyeball, and dysphagia were also present. Anti-allergic treatment did not resolve the symptoms. Patch tests revealed negative reactions to the rested reagents including titanium. Radiographic results showed solid bone fusion and no signs of chronic inflammation or hypotoxic infection in the surrounding tissues. Upon the patient's request, we removed the titanium screws and plate of the Zero-P device. No allergic reactions were observed after the surgery and at a 6-month follow-up.
Even with a small implant such as the Zero-P device, allergy to titanium may still occur. This case demonstrated the need to screen for the presence of allergy to metals including titanium before the surgery.
有报道称存在对大型外科植入物过敏的病例。然而，鲜有研究报道过对小型含钛植入物（如 Zero-P 装置）过敏的情况。
我们报告了一例 51 岁男性患者，他在接受 Zero-P 装置前路颈椎间盘切除术和融合术（ACDF）后 1 个月出现过敏症状。
过敏症状包括说话时间歇性喉咙刺痛和瘙痒。皮肤表面出现全身性皮疹和眼球充血，以及吞咽困难。抗过敏治疗未能缓解症状。斑贴试验显示对包括钛在内的备用试剂无反应。影像学结果显示骨融合牢固，周围组织无慢性炎症或低毒性感染迹象。应患者要求，我们取出了 Zero-P 装置的钛制螺钉和钢板。手术后和 6 个月随访时均未观察到过敏反应。
即使是像 Zero-P 装置这样的小型植入物，也可能发生对钛的过敏。本病例表明，在手术前需要筛查包括钛在内的金属过敏情况。
