Neurological emergency from rare spinal metalloma: Case report and literature review

David J. Mazur-Hart, Erik W. Larson, Nasser K. Yaghi, Aaron M. Halfpenny, David R. Pettersson, David A. Yam

Research output: Contribution to journalArticlepeer-review

Abstract

Metallosis is a rare and poorly understood long-term complication of instrumented surgery that can result in an inflammatory pseudotumor termed metalloma. We describe a particularly unique case and compare it to 6 analogous cases identified by PubMed and/or Medline search through July 2020. A 79-year-old male with multiple prior spinal lumbar fusion procedures presented with progressive weakness and pain. Imaging revealed a large mass surrounding the right-sided paraspinal rod with extension into the spinal canal, neural foramina, extraforaminal spaces, psoas muscle, marrow spaces, and right sided pedicles. The case presented is a unique example of a unilateral metalloma with mixed-metal instrumentation that created a progressive neurologic deficit without infection, pseudoarthrosis, or hardware failure. This case highlights the lack of understanding regarding the pathophysiology of metallosis and metalloma in spinal instrumentation. We highlight the imaging findings of metalloma to encourage early identification for removal and decompression.

Original languageEnglish (US)
Pages (from-to)1540-1548
Number of pages9
JournalRadiology Case Reports
Volume17
Issue number5
DOIs
StatePublished - May 2022
Externally publishedYes

Keywords

  • Instrumentation
  • Metalloma
  • Metallosis
  • Spinal
  • Spine

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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