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Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty

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Abstract

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.

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Notes

  1. Cases with values between 1.5 and 3 lengths from the upper or lower edge of the box are defined as outlier. The box length is the interquartile range (25–75 %), (SPSS ver. 10.05).

  2. Cases with values more than three box lengths from the upper or lower edge of the box are defined as extreme. The box length is the interquartile range (25–75 %), (SPSS ver. 10.05).

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Acknowledgments

This investigational device exemption study was sponsored by Medtronic, Memphis, TN.

Conflict of interest

Gornet—Royalties and Royalty payments with Medtronic. Burkus—Patent Holder with Medtronic and Royalties and Royalty payments with Medtronic. Harper—Employee of Medtronic. Chan—None Skipor—Institutional Funds are received from Medtronic Spinal and Biologics. Jacobs—Consultant: Zimmer, Medtronic, Johnson and Johnson, Smith and Nephew. Spinal Motion Research Funding: Medtronic, Zimmer and Spinal Motion.

Author information

Authors and Affiliations

  1. Spine Research Center, The Orthopedic Center of St. Louis, 14825 North Outer Forty Road, Suite 320, St. Louis, MO, 63017, USA

    Matthew F. Gornet

  2. Hughston Clinic, 6262 Veterans Parkway, Columbus, GA, 31908, USA

    J. K. Burkus

  3. Medtronic, AF Solutions, 8200 Corel Sea Street NE, Minneapolis, MN, 55112, USA

    M. L. Harper

  4. Covidien, Respiratory and Monitoring Solutions, 6135 Gunbarrel Avenue, Boulder, CO, 80301, USA

    F. W. Chan

  5. Rush University Medical Center, 1735 W. Harrison, Chicago, IL, 60612, USA

    A. K. Skipor & J. J. Jacobs

Authors
  1. Matthew F. Gornet
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  2. J. K. Burkus
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Corresponding author

Correspondence to Matthew F. Gornet.

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Gornet, M.F., Burkus, J.K., Harper, M.L. et al. Prospective study on serum metal levels in patients with metal-on-metal lumbar disc arthroplasty. Eur Spine J 22, 741–746 (2013). https://doi.org/10.1007/s00586-012-2581-8

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  • DOI: https://doi.org/10.1007/s00586-012-2581-8

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