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Radicular Pain due to Subsidence of the Nitinol Shape Memory Loop for Stabilization after Lumbar Decompressive Laminectomy

  • Son, Byung-Chul (Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Kim, Deog-Ryeong (Department of Neurosurgery, Nowon Eulji Hospital, Eulji University)
  • Received : 2013.11.09
  • Accepted : 2014.05.05
  • Published : 2015.01.28

Abstract

A number of dynamic stabilization systems have been used to overcome the problems associated with spinal fusion with rigid fixation recently and the demand for an ideal dynamic stabilization system is greater for younger patients with multisegment disc degeneration. Nitinol, a shape memory alloy of nickel and titanium, is flexible at low temperatures and regains its original shape when heated, and the Nitinol shape memory loop (SML) implant has been used as a posterior tension band mostly in decompressive laminectomy cases because the Nitinol implant has various characteristics such as high elasticity and a tensile force, flexibility, and biological compatibility. The reported short-term outcomes of the application of SMLs as posterior column supporters in cervical and lumbar decompressive laminectomies seem to be positive, and complications are minimal except for the rare occurrence of pullout and fracture of the SML. However, there was no report of neurological complications related to neural compression in spite of the use of the loop of SML in the epidural space. The authors report a case of delayed development of radiating pain caused by subsidence of the SML resulting epidural compression.

Keywords

References

  1. Braun JT, Akyuz E, Udall H, Ogilvie JW, Brodke DS, Bachus KN : Threedimensional analysis of 2 fusionless scoliosis treatments : a flexible ligament tether versus a rigid-shape memory alloy staple. Spine (Phila Pa 1976) 31 : 262-268, 2006 https://doi.org/10.1097/01.brs.0000197569.13266.fe
  2. Il'in AA, Kollerov MY, Khachin VI, GusevDA : Medical instruments and implants of titanium nicklide : physical metallurgy, technology, and application. Russian Metallurgy (Metally) 3 : 296-300, 2002
  3. Il'in AA, Kollerov MY, Sergeyv SV, Zagorodnyj NV, Radnaeyv EB, Nevzorov AV, et al. : [Biologically and mechanically compatible implants from titanium nickelide in the treatment of damaged dorsal and lumbar spine]. Bull Traumatol Orthop 2 : 19-26, 2002
  4. Kim DG, Eun JP, Park JS : Posterior cervical fixation with a nitinol shape memory loop for primary surgical stabilization of atlantoaxial instability : a preliminary report. J Korean Neurosurg Soc 52 : 21-26, 2012 https://doi.org/10.3340/jkns.2012.52.1.21
  5. Kim YS, Zhang HY : Shape memory implant (KIMPF fixing) system in Kim DH, Cammisa FP Jr, Fessler RG (eds) : Dynamic reconstruction of the spine. New York : Thieme, 2006, pp292-298
  6. Kim YS, Zhang HY, Moon BJ, Park KW, Ji KY, Lee WC, et al. : Nitinol spring rod dynamic stabilization system and Nitinol memory loops in surgical treatment for lumbar disc disorders : short-term follow up. Neurosurg Focus 22 : E10, 2007
  7. Mulholland RC, Sengupta DK : Rationale, principles and experimental evaluation of the concept of soft stabilization. Eur Spine J 11 Suppl 2 : S198-S205, 2002
  8. Sanders JO, Sanders AE, More R, Ashman RB : A preliminary investigation of shape memory alloys in the surgical correction of scoliosis. Spine (Phila Pa 1976) 18 : 1640-1646, 1993 https://doi.org/10.1097/00007632-199309000-00012
  9. Sengupta DK : Dynamic stabilization devices in the treatment of low back pain. Orthop Clin North Am 35 : 43-56, 2004 https://doi.org/10.1016/S0030-5898(03)00087-7
  10. Stoll TM, Dubois G, Schwarzenbach O : The dynamic neutralization system for the spine : a multi-center study of a novel non-fusion system. Eur Spine J 11 Suppl 2 : S170-S178, 2002
  11. Wever DJ, Elstrodt JA, Veldhuizen AG, v Horn JR : Scoliosis correction with shape-memory metal : results of an experimental study. Eur Spine J 11 : 100-106, 2002 https://doi.org/10.1007/s005860100347
  12. Yu DK, Heo DH, Cho SM, Choi JH, Sheen SH, Cho YJ : Posterior cervical fixation with nitinol shape memory loop in the anterior-posterior combined approach for the patients with three column injury of the cervical spine : preliminary report. J Korean Neurosurg Soc 44 : 303-307, 2008 https://doi.org/10.3340/jkns.2008.44.5.303