Abnormal metal ion levels following spinal instrumentation surgery
Notice bibliographique
Résumé
The incidence of abnormal metal ion levels following spinal surgery has been inconsistent across various studies. Metal implants, commonly used in spinal surgeries, can release ions that may accumulate in the bloodstream, leading to potential adverse health effects. Therefore, a comprehensive meta-analysis is necessary to assess the levels of metal ions in patients after spinal surgery. We performed a systematic review and meta-analysis to evaluate metal ion levels after spinal surgery. A thorough search was conducted across four databases (PubMed, Embase, Web of Science, and Cochrane Library) up to September 2024. Studies were included if they measured serum or whole blood levels of metals such as chromium, cobalt, titanium, nickel, aluminum, or other relevant ions in patients post-spinal surgery. Data were extracted and analyzed using random-effects models to account for variability between studies. Funnel plots and Egger’s test were used to assess publication bias, and I2 statistics were employed to measure heterogeneity. Sensitivity analyses of the included studies were conducted to ensure the robustness of the findings. The Newcastle–Ottawa Scale (NOS) was used for quality assessment, evaluating factors such as study selection, comparability, and outcome measurement. A total of thirty-one studies, comprising data from over 1,404 patients, met the inclusion criteria. Postoperative levels of chromium, titanium, cobalt, aluminum, and nickel were significantly elevated compared to preoperative levels. The pooled standardized mean difference (SMD) for chromium was 2.50 (95% CI 1.74–3.26), for titanium was 2.05 (95% CI 1.41–2.70), for cobalt was 2.28 (95% CI 1.24–3.32), for aluminum was 0.75 (95% CI 0.24–1.27), and for nickel was 1.41 (95% CI 0.03–2.79). Subgroup analyses revealed variations based on the type of surgery, with higher SMDs observed in degenerative spinal conditions compared to scoliosis and spinal deformity-related surgeries for most metals. Significant heterogeneity was observed among studies (I2 > 70%), but no evidence of publication bias was detected. Sensitivity analyses confirmed the stability of the results. This meta-analysis confirms a significant postoperative increase in metal ion levels, particularly for chromium, titanium, cobalt, aluminum, and nickel, in patients following spinal surgery. These elevated metal ion levels raise concerns about potential long-term health risks, underscoring the importance of postoperative monitoring. Given the high heterogeneity among studies, more robust and standardized research is needed to establish clear clinical thresholds for safe metal ion levels and to assess the long-term implications of these findings. Regular monitoring of metal ion concentrations in patients with spinal implants may be crucial for early detection and prevention of metal-related complications.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,019 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,002 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,001 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».