Biocompatibility of Metallic Spinal Implants

  • Gregory J. Bennett
Conference paper
Part of the Contemporary Perspectives in Neurosurgery book series (COPENEU)

Abstract

Lumbar stabilization surgery has increasingly utilized metallic implants in various forms. The intended effect of most implants is to provide sufficient stiffness to the spine to facilitate a bone fusion across motion segments. Spinal implants may have many other effects including local and systemic chemical and immunological effects, and biomechanically induced changes in surrounding bone, such as pressure necrosis, remodeling, and osteopenia (8,13). Because of the biomechanical variations in spinal instability syndromes and possibly also the biological capability for bone formation and incorporation, the implant design and surgical construct remain diverse and their relative merits are poorly understood. However, in general, the implants are considered temporary “splints” for support and load sharing with the spine in anticipation of an eventual bone fusion. Once the fusion has occurred, their contribution to spine stability and patient comfort and activities becomes less apparent. Nevertheless, most implants are left in place after the fusion matures. This raises the possibility of deriving additional long-term benefits from the presence of the implant or, alternatively, the possibility of accumulative biologic toxicity or undesirable biomechanical consequences.

Keywords

Fatigue Titanium Porosity Nickel Toxicity 

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Copyright information

© Springer-Verlag New York, Inc. 1993

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  • Gregory J. Bennett

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