Epidural Metalloma 12 Years After Spinal Fusion for Adolescent Idiopathic Scoliosis: A Case Report.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 41054752.
- Also identified by DOI 10.1007/s43465-025-01425-2 and PMC identifier 12496324.
- Licence recorded as CC BY.
- The licence permits redistribution, so the abstract is shown in full and the full text is available from the publisher.
Abstract
The occurrence of metallosis after spine surgery is a rare phenomenon. The accumulation and deposition of metallic nanoparticles, especially cobalt and chromium, elicit a local inflammatory response by modulating the expression of cytokines, ultimately manifesting as a pseudotumor. This process is considered an aseptic lymphocyte-dominated vasculitis-associated lesion or adverse local tissue reaction (ALTR). We present a case of metalloma that developed 12 years after surgery for adolescent idiopathic scoliosis (AIS). After a piecemeal decompression of the pseudocyst, additional internal fixation instrumentation, and a pseudarthrosis revision with bone transplantation, the patient regained all prior flexibility and remained pain free. We speculate that the proposed mechanism of instrumentation failure in our patient was over-aggressive postoperative exercise with pseudoarthrosis and metal-on-metal corrosion, leading to ALTR in the spinal canal.