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Introduction <p>&#xa0;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). </p> Methods <p>We present a case of metalloma that developed 12&#xa0;years after surgery for adolescent idiopathic scoliosis (AIS).</p> Results <p>After a piecemeal decompression of the pseudocyst, additional internal fixation instrumentation, and a pseudarthrosis revision with bone transplantation, the&#xa0;patient regained all prior flexibility and remained pain free.</p> Conclusion <p>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. </p>

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Epidural Metalloma 12 Years After Spinal Fusion for Adolescent Idiopathic Scoliosis: A Case Report

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年6月2日

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  • Janez Mohar,
  • René Mihalič,
  • Dejan Čeleš

摘要

Introduction

 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).

Methods

We present a case of metalloma that developed 12 years after surgery for adolescent idiopathic scoliosis (AIS).

Results

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.

Conclusion

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.