Background:
Spine surgeons rarely consider metal allergies when placing hardware, as implants are thought to be inert.
Case description:
A 32-year-old male presented with a skin rash attributed to the trace metal in his spinal fusion instrumentation. Patch testing revealed sensitivities to cobalt, manganese, and chromium. He underwent hardware removal and replacement with constructs of commercially pure titanium. His skin findings resolved at 2 weeks after surgery and were stable at 6 weeks.
Conclusion:
Hypersensitivity to metal (i.e., metal allergy) should be considered before performing instrumented spinal fusions.