Evaluation of systemic metal diffusion after spinal pedicular fixation with titanium alloy and stainless steel system: a 36-month experimental study in sheep
Evaluation of systemic metal diffusion after spinal pedicular fixation with titanium alloy and stainless steel system: a 36-month experimental study in sheep
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DOI：
10.1177/039139880102400108
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发表时间：
2001-01-01
影响因子：
1.7
通讯作者：
Giardino, R
中科院分区：
文献类型：
--
作者：
Brayda-Bruno, M;Fini, M;Giardino, R
众所周知，钛合金由于微动腐蚀比不锈钢植入物引起更广泛的局部金属沉着，本研究的目的是研究在绵羊L4-L5植入钛合金（Ti6 Al 4V; ASTM F 136）和不锈钢（AISI 316 L）时可能的全身金属释放（Ti，Al，V，Cr，Ni）。使用了16只绵羊：8只植入了Ti6 Al 4V，8只植入了不锈钢。在6、12、24和36个月时，对肝、肺、肾、脑、脾和腰主动脉淋巴结进行组织学、原子吸收分光光度法（AAS）和扫描电镜（SEM）检查。在植入前和处死时，还通过AAS分析了毛发、尿液和动脉血样本。对种植体周围组织进行了组织学和超微结构研究。特别注意避免来自解剖工具或使用容器的污染。在基底和6个月和12个月的样本中，在植入Ti6 Al 4V或不锈钢的动物的血液、尿液、毛发或其他靶组织中未发现金属。关于Al、V、Co和Ni，在24个月和36个月时，所有组织和体液均获得阴性结果。相反，在24个月时，仅在一只绵羊的腰主动脉淋巴结和肺中发现了微量Ti（分别为10和30 ng/g）。在36个月时，除了体液和毛发外，在植入Ti6 Al 4V（2-16.5 ng/g）的两只绵羊的所有组织中均观察到Ti的全身扩散。目前的数据表明，椎弓根稳定固定后器官中发现的钛含量极低，且无生物学可用性。这一观察结果将使我们排除任何毒性反应的假设，这种释放似乎是由于通过淋巴液的被动扩散。需要进行额外的研究来确认钛颗粒的长期释放是否会导致组织损伤。
It is known that titanium alloys cause more extensive local metallosis due to fretting corrosion than stainless steel implants.The aim of the present study was to investigate possible systemic metal releases (Ti, Al, V, Cr, Ni) in sheep where L4-L5 were implanted with titanium alloy (Ti6Al4V; ASTM F 136) and stainless steel (AISI 316 L). 16 sheep were used: 8 were implanted with Ti6Al4V and 8 with stainless steel. At 6 12, 24 and 36 months, the following examinations were performed: histology, atomic absorption spectrophotometry (AAS) and scanning electron microscopy (SEM), on liver, lung, kidney, brain, spleen and lumbo-aortic lymph nodes. Hair, urine and arteria blood samples were also analysed by AAS before implantation and at sacrifices. A histologic and ultrastructural study was performed on peri-implant tissues, too. Particular attention was paid to avoid contamination from dissection instruments or use of containers. In basal and in samples at 6 and 12 months, no metals were found in blood, urine, hair or other target tissues of the animals implanted with either Ti6Al4V or stainless steel. Regarding Al, V; Co and Ni, negative results in all tissues and body fluids were obtained also at 24 and 36 months. On the contrary, Ti traces were found in lumbo-aortic lymph nodes and lungs of one sheep only (10 and 30 ng/g, respectively) at 24 months. At 36 months, a systemic diffusion of Ti was observed in all tissues of both sheep instrumented with Ti6Al4V (2-16.5 ng/g), except for body fluids and hair.Metal research in target tissues by light and SEM micro-probe analysis provided negative results. Current data suggest that the amount of Ti found in organs after stable pedicular fixation is extremely low and not biologically available. This observation would lead us to exclude the hypothesis of any toxic reaction and such a release seems to be due to the passive diffusion through lymphatic fluids. Additional studies are needed to confirm if this long-term release of Ti particles might cause tissue damage.