Delayed Hypersensitivity Reaction: An Increasingly Recognized Complication of Metal-on-Metal Total Disc Replacement.
We report the case of a 32-year-old woman who presented with pain recurrence 20 months after she underwent a C5C6 metal-on-metal total replacement. Plan radiographs demonstrated a modification of the shape of the vertebral bodies making the prosthesis more protruding. Then, infection has been ruled out and patch testing revealed a strongly positive reaction for chromium and cobalt. The prosthesis has been removed and a fusion achieved using a cage filled with bone graft. She has been immediately and fully relieved from her pain. We report the radiological signs that enabled early diagnosis and treatment allowing favorable outcome.
Department of Neurosurgery, Lille University Hospital, CHRU de Lille, 59000 Lille, France.
Mélodie-Anne
MA
Karnoub
Department of Neurosurgery, Lille University Hospital, CHRU de Lille, 59000 Lille, France.
Fahed
F
Zairi
Department of Neurosurgery, Lille University Hospital, CHRU de Lille, 59000 Lille, France.
Rabih
R
Aboukais
Department of Neurosurgery, Lille University Hospital, CHRU de Lille, 59000 Lille, France.
Richard
R
Assaker