{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T16:17:52Z","timestamp":1775837872757,"version":"3.50.1"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,12]]},"abstract":"\n Study design:<\/jats:title>\n A case report.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n To inform the spine surgeons another cause of late complications after instrumented spinal fusion surgery.<\/jats:p>\n <\/jats:sec>\n \n Summary of Background Data:<\/jats:title>\n Posterior lumbar instrumented fusion has been widely applied as an effective procedure for treating patients with degenerative lumbar spine disease. The development of pathology at the mobile segment adjacent to the lumbar spinal fusion has been termed as adjacent segment disease.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Most patients with adjacent segment disease present with recurrent back pain, sciatica, intermittent claudication, or even muscle weakness. Herein, we report the case of a 58-year-old man with posterior lumbar instrumented fusion at L4\u2013L5 who complained of recurrent neurological symptoms mimicking adjacent instability and stenosis. In addition to severe adjacent stenosis at L3\u2013L4, preoperative magnetic resonance imaging showed an intraspinal extradural tumor-like mass with compression of the neurological elements.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n The well-capsulated tumor mass was gently dissected and meticulously excised without injury to the adhesive dura or nerve roots. The tumor specimen was fixed in formalin, and then decalcified and tinted using several special stains, which conformed metallic wear debris, resulting in foreign body reaction.<\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n The metallic wear particulates may initiate a cascade of immune and inflammatory responses. Therefore, attention should be paid to patients who are found to have loosening of the implants at the metal-metal or metal-bone interface.<\/jats:p>\n <\/jats:sec>","DOI":"10.1097\/bsd.0b013e318292e685","type":"journal-article","created":{"date-parts":[[2013,4,23]],"date-time":"2013-04-23T13:35:07Z","timestamp":1366724107000},"page":"E532-E535","source":"Crossref","is-referenced-by-count":5,"title":["Capsulated Metallic Debris Tumor Mass Mimicking Adjacent Segment Disease"],"prefix":"10.1097","volume":"29","author":[{"given":"Yi-Chen","family":"Li","sequence":"first","affiliation":[{"name":"Orthopaedic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shih-Chieh","family":"Yang","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao-Tien","family":"Hsu","sequence":"additional","affiliation":[{"name":"Pathology, E-Da Hospital, I-Shou University, Kaohsiung County, Taiwan, R.O.C"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan-Kun","family":"Tu","sequence":"additional","affiliation":[{"name":"Orthopaedic Surgery"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20231002","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1097\/01.brs.0000137069.88904.03","article-title":"Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature","volume":"29","author":"Park","year":"2004","journal-title":"Spine"},{"key":"R2-20231002","doi-asserted-by":"crossref","first-page":"2253","DOI":"10.1097\/BRS.0b013e31814b2d8e","article-title":"Adjacent segment disease following lumbar\/thoracolumbar fusion with pedicle screw instrumentation: a minimum 5-year follow-up","volume":"32","author":"Cheh","year":"2007","journal-title":"Spine"},{"key":"R3-20231002","doi-asserted-by":"crossref","first-page":"970","DOI":"10.1097\/00007632-199604150-00013","article-title":"Lumbar motion segment pathology adjacent to thoracolumbar, lumbar, and lumbosacral fusions","volume":"21","author":"Schlegel","year":"1996","journal-title":"Spine"},{"key":"R4-20231002","doi-asserted-by":"crossref","first-page":"E519","DOI":"10.1097\/00007632-200111150-00024","article-title":"Surgical treatment of adjacent instability after lumbar spine fusion","volume":"26","author":"Chen","year":"2001","journal-title":"Spine"},{"key":"R5-20231002","doi-asserted-by":"crossref","first-page":"E1079","DOI":"10.3928\/01477447-20120621-26","article-title":"Percutaneous vertebroplasty for symptomatic osteoporotic vertebral compression fracture adjacent to lumbar instrumented circumferential fusion","volume":"35","author":"Yang","year":"2012","journal-title":"Orthopedics"},{"key":"R6-20231002","doi-asserted-by":"crossref","first-page":"S206","DOI":"10.1097\/00003086-199608001-00018","article-title":"Metal versus polyethylene wear particles in total hip replacements. A review","volume":"329","author":"Doorn","year":"1996","journal-title":"Clin Orthop Relat Res"},{"key":"R7-20231002","doi-asserted-by":"crossref","first-page":"S187","DOI":"10.1097\/00003086-199608001-00017","article-title":"Tissue reaction to metal on metal total hip prostheses","volume":"329","author":"Doorn","year":"1996","journal-title":"Clin Orthop Relat Res"},{"key":"R8-20231002","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1016\/0883-5403(94)90084-1","article-title":"Particulate titanium and cobalt-chrome metallic debris in failed total knee arthroplasty. A quantitative histologic analysis","volume":"9","author":"La Budde","year":"1994","journal-title":"J Arthroplasty"},{"key":"R9-20231002","doi-asserted-by":"crossref","first-page":"S128","DOI":"10.1097\/00003086-199608001-00013","article-title":"In vivo wear of three types of metal on metal hip prostheses during two decades of use","volume":"329","author":"McKellop","year":"1996","journal-title":"Clin Orthop Relat Res"},{"key":"R10-20231002","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1302\/0301-620X.73B4.2071635","article-title":"Metal wear and tissue response in failed titanium alloy total hip replacements","volume":"73","author":"Witt","year":"1991","journal-title":"J Bone Joint Surg Br"},{"key":"R11-20231002","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1097\/00007632-200107010-00024","article-title":"Intraspinal metallosis causing delayed neurologic symptoms after spinal instrumentation surgery","volume":"26","author":"Takahashi","year":"2001","journal-title":"Spine"},{"key":"R12-20231002","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.2106\/JBJS.H.01625","article-title":"A granulomatous mass surrounding a Maverick total disc replacement causing iliac vein occlusion and spinal stenosis: a case report","volume":"92","author":"Berry","year":"2010","journal-title":"J Bone Joint Surg Am"},{"key":"R13-20231002","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1097\/00007632-199905010-00011","article-title":"Metal debris from titanium spinal implants","volume":"24","author":"Wang","year":"1999","journal-title":"Spine"},{"key":"R14-20231002","doi-asserted-by":"crossref","first-page":"1971","DOI":"10.1097\/00007632-200209150-00004","article-title":"The effect of titanium particulate on development and maintenance of a posterolateral spinal arthrodesis: an in vivo rabbit model","volume":"27","author":"Cunningham","year":"2002","journal-title":"Spine"},{"key":"R15-20231002","doi-asserted-by":"crossref","first-page":"1320","DOI":"10.1097\/01.BRS.0000065482.41115.B4","article-title":"Metal concentrations in the serum and hair of patients with titanium alloy spinal implants","volume":"28","author":"Kasai","year":"2003","journal-title":"Spine"},{"key":"R16-20231002","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1097\/00003086-199401000-00016","article-title":"Implant failure and the immuno-incompetent fibro-inflammatory zone","volume":"298","author":"Gristina","year":"1994","journal-title":"Clin Orthop Relat Res"}],"container-title":["Clinical Spine Surgery: A Spine Publication"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/01933606-201612000-00017","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T19:02:26Z","timestamp":1696273346000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/01933606-201612000-00017"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2016,12]]},"references-count":16,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2016]]}},"URL":"https:\/\/doi.org\/10.1097\/bsd.0b013e318292e685","relation":{},"ISSN":["2380-0186"],"issn-type":[{"value":"2380-0186","type":"print"}],"subject":[],"published":{"date-parts":[[2016,12]]}}}