Department of Paediatric Orthopaedics, Medical University of Lublin, Lublin, Poland.
Department of Analytical Chemistry, Medical University of Lublin, Lublin, Poland.
Spine (Phila Pa 1976). 2021 May 15;46(10):E594-E601. doi: 10.1097/BRS.0000000000003846.
Case-control study.
The aim of the study was to compare growth-friendly systems: traditional growing rod, guided growth systems (GGS), and vertical expandable prosthetic titanium rib in the context of titanium release.
The problem of scoliosis affects even up to 3% of the population, and ca. 0.1% of patients need surgical treatment. Surgical treatment carries the risk of a long-term presence of implants in the organism, which may result in release of metal ions into the tissues and bloodstream.
Seventy-one patients (13.5 ± 3.54 years' old) were treated for spinal deformity using various surgical systems and the samples of paraspinal tissue, blood, nails, and hair were collected before and after treatment. The quantification of titanium was performed using inductively coupled plasma optical emission spectrometry.
The metallic particles were released into the peri-implant tissue, and the greatest amounts of titanium were detected in patients with GGS. The concentration of soluble titanium forms in subcutaneous tissue (ST) was low and do not statistically differ from control. The average titanium content in the paraspinal tissue in patients with GGS was two- to three-fold higher than the average value in the other investigated groups. A slightly increased level of titanium compared with the control was noted in all studied groups of patients. The highest content of titanium in blood was observed in patients with the GGS system.
Neverless the system used, the concentration of soluble titanium forms in both ST and blood was only slightly higher than in the control and did not exceed the allowable levels. The increased level of titanium with GGS system is probably associated with the friction between implant components, whereas the components in the other systems are immobile relative to each other.Level of Evidence: 3.
病例对照研究。
本研究旨在比较生长友好型系统：传统生长棒、引导生长系统（GGS）和可垂直扩展的钛肋骨假体，同时考虑钛释放的情况。
脊柱侧弯问题甚至影响到 3%的人群，约 0.1%的患者需要手术治疗。手术治疗存在长期在体内存在植入物的风险，这可能导致金属离子释放到组织和血液中。
71 名（13.5±3.54 岁）脊柱畸形患者接受了各种手术系统的治疗，并在治疗前后采集了脊柱旁组织、血液、指甲和头发样本。使用电感耦合等离子体发射光谱法进行钛的定量分析。
金属颗粒释放到植入物周围组织中，GGS 患者中检测到的钛含量最高。皮下组织（ST）中可溶性钛形态的浓度较低，与对照组无统计学差异。GGS 患者的脊柱旁组织中的平均钛含量比其他研究组的平均值高出两到三倍。与对照组相比，所有研究组的患者均略有增加的钛含量。在 GGS 系统的患者中观察到血液中的钛含量最高。
无论使用哪种系统，ST 和血液中的可溶性钛形态浓度仅略高于对照组，并未超过允许水平。GGS 系统中钛含量的增加可能与植入物组件之间的摩擦有关，而其他系统中的组件彼此之间相对不动。
3 级。
