title: Is galvanic corrosion between titanium alloy and stainless steel spinal implants a clinical concern?
abstract: BACKGROUND
  Surgeons are hesitant to mix components made of differing metal classes for fear of galvanic corrosion complications. However, in vitro studies have failed to show a significant potential for galvanic corrosion between titanium and stainless steel, the two primary metallic alloys used for spinal implants. Galvanic corrosion resulting from metal mixing has not been described in the literature for spinal implant systems.
  
  
  OBJECTIVE
  To determine whether galvanic potential significantly affects in vitro corrosion of titanium and stainless steel spinal implant components during cyclical compression bending.
  
  
  METHODS
  Bilateral spinal implant constructs consisting of pedicle screws, slotted connectors, 6.35-mm diameter rods and a transverse rod connector assembled in polyethylene test blocks were tested in vitro. Two constructs had stainless steel rods with mixed stainless steel (SS-SS) and titanium (SS-Ti) components, and two constructs had titanium rods with mixed stainless steel (Ti-SS) and titanium (Ti-Ti) components.
  
  
  METHODS
  Each construct was immersed in phosphate-buffered saline (pH 7.4) at 37 C and tested in cyclic compression bending using a sinusoidal load-controlling function with a peak load of 300 N and a frequency of 5 Hz until a level of 5 million cycles was reached. The samples were then removed and analyzed visually for evidence of corrosion. In addition, scanning electron microscopy (SEM) and energy dispersive spectrometry (EDS) were used to evaluate the extent of corrosion at the interconnections.
  
  
  RESULTS
  None of the constructs failed during testing. Gross observation of the implant components after disassembly revealed that no corrosion had occurred on the surface of the implants that had not been in contact with another component. The Ti-Ti interfaces showed some minor signs of corrosion only detectable using SEM and EDS. The greatest amount of corrosion occurred at the SS-SS interfaces and was qualitatively less at the SS-Ti and Ti-SS interfaces.
  
  
  CONCLUSIONS
  The results from this study indicate that when loaded dynamically in saline, stainless steel implant components have a greater susceptibility to corrosion than titanium. Furthermore, the galvanic potential between the dissimilar metals does not cause a discernible effect on the corrosion of either. Although the mixture of titanium alloy with stainless steel is not advocated, the results of this study suggest that galvanic corrosion is less pronounced in SS-Ti mixed interfaces than in all stainless steel constructs.
authors.affiliation: DePuy Spine, Inc., 325 Paramount Drive, Raynham, MA 02767, USA. hserhan@dpyus.jnj.com
authors.forename: Hassan
authors.initials: H
authors.lastname: Serhan
authors.forename: Michael
authors.initials: M
authors.lastname: Slivka
authors.forename: Todd
authors.initials: T
authors.lastname: Albert
authors.forename: S Daniel
authors.initials: SD
authors.lastname: Kwak
mesh_terms: D000497:Alloys; D020099:Coated Materials, Biocompatible; D066298:In Vitro Techniques; D016268:Internal Fixators; D008422:Materials Testing; D008953:Models, Anatomic; D019736:Prostheses and Implants; D011474:Prosthesis Design; D012680:Sensitivity and Specificity; D013123:Spinal Fusion / Q000295:instrumentation* / Q000379:methods; D013193:Stainless Steel; D014025:Titanium
chemical_list: D000497:Alloys; D020099:Coated Materials, Biocompatible; D013193:Stainless Steel; D014025:Titanium