Teenagers, Spine Fusion, and Heavy Metals

When children and adolescents have a spinal fusion special rods, screws, and hooks may be used. These implants hold the spine in place until the bone graft grows enough to fuse the spine. This study looks at the blood levels of metals such as nickel and chromium used in the implants.

Metal implants do breakdown. They can release metal ions into the body. Long-term exposure to these metals may be toxic. A few studies have shown a link between leukemia and lymphoma and metal hip joint replacements. These findings led researchers to wonder if children with implants are at risk. Their young age when the spinal implants are used may expose them to toxic metals for years.

To answer this question, blood levels of nickel and chromium were measured in 37 adults who had metal implants used in the spine when they were teenagers. They found elevated levels of both nickel and chromium. Levels were above normal right after surgery, two years later, and remained elevated four years or more after the operation.

The authors say that levels of chromium in this group were equal to blood levels seen in adults after a metal hip joint replacement. The long-term effects of elevated levels of metals in spinal fusion patients are unknown. For now it is news worthy that the levels are above normal. Problems related to toxicity may occur years after the fusion. More studies are needed in this area.

Young-Jo Kim, MD, PhD, et al. Serum Levels of Nickel and Chromium after Instrumented Posterior Spinal Arthrodesis. In Spine. April 15, 2005. Vol. 30. No. 8. Pp. 923-926.



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