{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T03:36:44Z","timestamp":1787888204482,"version":"build-2784847793"},"reference-count":8,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SPI"],"published-print":{"date-parts":[[2013,9]]},"abstract":"<jats:p>The authors report the case of a 53-year-old woman who underwent placement of a metal-on-metal total disc replacement (TDR) device for the treatment of discogenic back pain. The initial postoperative course was normal, but 2 months after surgery she started to complain of a recurrence of pain and she progressively developed cauda equina syndrome. Radiological and biological findings showed an inflammatory polyneuropathy associated with an epidural mass. A diagnosis of cell-mediated hypersensitivity reaction (Type IV) was made after patch testing showed positive reactions for 1% cobalt chloride and chromium. A decision was made to remove the TDR device and to perform a circumferential fusion. This report is intended to inform the reader that systemic metal release and hypersensitivity reaction are possible complications of metal-on-metal TDR.<\/jats:p>","DOI":"10.3171\/2013.6.spine121010","type":"journal-article","created":{"date-parts":[[2013,7,5]],"date-time":"2013-07-05T13:56:36Z","timestamp":1373032596000},"page":"389-391","source":"Crossref","is-referenced-by-count":16,"title":["Delayed hypersensitivity reaction caused by metal-on-metal total disc replacement"],"prefix":"10.3171","volume":"19","author":[{"given":"Fahed","family":"Zairi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Lille University Hospital, Lille, France; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean Michel","family":"Remacle","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, CHR Citadelle, Li\u00e8ge, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Allaoui","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Lille University Hospital, Lille, France; 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