title: Failure of a carbon fiber implant. A case report.
abstract: METHODS
  Case report.
  
  
  OBJECTIVE
  Failure of a carbon fiber implant.
  
  
  BACKGROUND
  To simplify the procedure of posterior lumbar interbody fusion, a carbon-fiber-reinforced polymer implant has been developed. The implant has ridges to resist retropulsion, struts to support weight, and a hollow area to allow packing of autologous bone graft. So far, no complications have been reported from the use of carbon implant as a fusion aid in spine surgery.
  
  
  METHODS
  A patient with postoperative infection has been followed with computed tomography images and histologic examination from a reoperation.
  
  
  RESULTS
  An entire nonunion across the width of the disc space and a clearly broken cage was visualized with computed tomography. The spinal canal was explored during a reoperation and the tissue surrounding the dura and nerves were all black. Microscopic examination showed a large quantity of carbon particulate debris. The authors have operated on approximately 100 patients so far and no other carbon cage has broken, to their knowledge.
  
  
  CONCLUSIONS
  Carbon cages can break if a nonunion occurs and as a result free carbon particles move out to the spinal canal.
authors.affiliation: Department of Orthopaedics, St. Görans Hospital, Stockholm, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Tullberg
mesh_terms: D000328:Adult; D001672:Biocompatible Materials; D002244:Carbon; D000077482:Carbon Fiber; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D006801:Humans; D016268:Internal Fixators / Q000009:adverse effects*; D007403:Intervertebral Disc / Q000473:pathology; D007710:Klebsiella Infections / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D019736:Prostheses and Implants; D011475:Prosthesis Failure; D016459:Prosthesis-Related Infections / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D012086:Reoperation; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013166:Spondylitis / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D001672:Biocompatible Materials; D000077482:Carbon Fiber; D002244:Carbon