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Levels of Cr, Co, and Ti were measured.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>In the 91 surgically treated individuals median levels of Cr were 0.54\u00a0\u00b5g\/l vs 0\u00a0\u00b5g\/l in the 91 controls, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001. Corresponding results for Co were 0.29\u00a0\u00b5g\/l vs. 0.24\u00a0\u00b5g\/l, <jats:italic>p<\/jats:italic>\u2009=\u20090.19, and for Ti were 0\u00a0\u00b5g\/l vs. 0\u00a0\u00b5g\/l, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001.<\/jats:p>\n                <jats:p>In the individuals with steel implants and their corresponding controls median Cr levels were 0.63\u00a0\u00b5g\/l vs. 0.00\u00a0\u00b5g\/l, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001 and Co levels 0.27\u00a0\u00b5g\/l vs. 0.23\u00a0\u00b5g\/l, <jats:italic>p<\/jats:italic>\u2009=\u20090.36. No Ti was detected.<\/jats:p>\n                <jats:p>In the individuals with titanium implants, median Cr levels were 0\u00a0\u00b5g\/l vs. 0\u00a0\u00b5g\/l in their corresponding controls, <jats:italic>p<\/jats:italic>\u2009=\u20090.38. Corresponding results for Co was 0.39\u00a0\u00b5g\/l vs. 0.31\u00a0\u00b5g\/l, <jats:italic>p<\/jats:italic>\u2009=\u20090.27 and for Ti 4.31\u00a0\u00b5g\/l vs. 0\u00a0\u00b5g\/l, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001.<\/jats:p>\n                <jats:p>In the individuals with steel implants a negative correlation between implant time in situ and levels of Cr was found (<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\rho$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                    <mml:mi>\u03c1<\/mml:mi>\n                  <\/mml:math><\/jats:alternatives><\/jats:inline-formula>\u2009=\u2009<jats:italic>\u2212<\/jats:italic> 0.52, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) but not with Co (<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\rho$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                    <mml:mi>\u03c1<\/mml:mi>\n                  <\/mml:math><\/jats:alternatives><\/jats:inline-formula>\u2009=\u2009<jats:italic>\u2212<\/jats:italic> 0.14, <jats:italic>p<\/jats:italic>\u2009=\u20090.23). Ti was not detected.<\/jats:p>\n                <jats:p>In the individuals with titanium implants, there was no correlation between implant time in situ and levels of Cr (<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\rho$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                    <mml:mi>\u03c1<\/mml:mi>\n                  <\/mml:math><\/jats:alternatives><\/jats:inline-formula>\u2009=\u20090.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.12), Co (<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\rho$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                    <mml:mi>\u03c1<\/mml:mi>\n                  <\/mml:math><\/jats:alternatives><\/jats:inline-formula>\u2009=\u2009<jats:italic>\u2212<\/jats:italic> 0.12, <jats:italic>p<\/jats:italic>\u2009=\u20090.60) or Ti (<jats:inline-formula><jats:alternatives><jats:tex-math>$$\\rho$$<\/jats:tex-math><mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\">\n                    <mml:mi>\u03c1<\/mml:mi>\n                  <\/mml:math><\/jats:alternatives><\/jats:inline-formula>\u2009=\u20090.22, <jats:italic>p<\/jats:italic>\u2009=\u20090.35).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The use of stainless steel and titanium implants in spinal fusion surgery is associated with elevated metal ion concentrations several years after surgery<jats:bold>.<\/jats:bold><\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00586-022-07341-5","type":"journal-article","created":{"date-parts":[[2022,9,14]],"date-time":"2022-09-14T11:03:00Z","timestamp":1663153380000},"page":"3036-3041","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Serum metal ion levels following spinal deformity surgery: a case-control study of 182 individuals"],"prefix":"10.1007","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5440-3559","authenticated-orcid":false,"given":"Daniel","family":"Fell","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4511-4349","authenticated-orcid":false,"given":"Elias","family":"Diarbakerli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8061-7163","authenticated-orcid":false,"given":"Paul","family":"Gerdhem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,9,14]]},"reference":[{"key":"7341_CR1","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1007\/s00776-004-0867-3","volume":"10","author":"T Akazawa","year":"2005","unstructured":"Akazawa T, Minami S, Takahashi K, Kotani T, Hanawa T, Moriya H (2005) Corrosion of spinal implants retrieved from patients with scoliosis. 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