Epidural metalloma 12 years after spinal fusion for adolescent idiopathic scoliosis : a case report

Mohar, Janez (author), Mihalič, Rene (author), Čeleš, Dejan (author)

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.

• Language: English
• Keywords: scoliosis, pseudoarthrosis, corrosion, neoplasms, return to sport
• Work type: Article
• Typology: 1.03 - Other scientific articles
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2025
• Number of pages: Str. 1585–1588
• Numbering: Vol. 59, iss. 9
• PID: 20.500.12556/RUL-178689
• UDC: 617.3
• ISSN on article: 0019-5413
• DOI: 10.1007/s43465-025-01425-2
• COBISS.SI-ID: 238033411
• Publication date in RUL: 29.01.2026

Record is a part of a journal

• Title: Indian journal of orthopaedics
• Shortened title: Indian j. orthop.
• Publisher: Springer Nature, Indian Orthopaedics Association
• ISSN: 0019-5413
• COBISS.SI-ID: 513923353

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: skolioza, psevdoartroza, korozija, neoplazme