For a study, researchers sought to develop that patients who underwent elective spinal deformity surgery in prospective research included preoperative controls and periodic assessments of circulating metal ions. The objective was to determine whether certain levels of circulating metal ions were maintained 2 years after surgery in relation to different implant systems and rods. Adults with hip replacements, particularly those with metal-on-metal bearings, may experience elevated levels of metal ions. Circulating metal ions, particularly those from titanium, chromium, cobalt, and nickel, have been linked to pediatric spinal implants. High-resolution inductively coupled plasma mass spectrometry was used to repeatedly test for circulating metal ions in 56 infants undergoing spinal deformity surgery. The amounts of titanium, cobalt, chromium, and nickel were examined using linear mixed-effects models that took repeated measurements over time into account. Titanium levels increased quickly, rising by 7 days, reaching a peak at 30 days, and practically holding steady at the 2-year assay. In comparison to the presurgery control level, titanium levels were 5.14 times higher at 2 years (P<0.0001). Cobalt levels grew gradually to a peak at 30 days, then fell gradually while continuing to be 1.74 times higher than the mean baseline level after 2 years (P=0.0004), with a diminishing trend. Chromium and nickel levels increased immediately following surgery, then gradually decreased to baseline by 6 months, where they remained for 2 years. Results from the 5 implant systems studied were largely comparable. In a society that was primarily made up of women, the constant and rising amounts of titanium were alarming. In rodents and humans, titanium has been shown to cross the placental barrier and enter the fetus’ circulation. It has also been shown to accumulate in solid organs, particularly in humans’ liver, spleen, heart, and lymph nodes. This could expose children of moms with spinal implants to titanium, which could have teratogenic effects.
