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- Title
Bone-anchored annular closure device leading to histiocytic-inflammation-induced neuropathy with resolution after removal: a case report.
- Authors
McClure, Jesse J.; Jentoft, Mark E.; Sandhu, Sukhwinder S.; Chen, Selby G.; Abode-Iyamah, Kingsley O.
- Abstract
Purpose: To determine and report the underlying cause of local inflammation causing recurrent neuropathy and multiple operations in a patient with a Barricaid® device. Methods: After removal of this patient's Barricaid® device, we sent local inflammatory tissue to pathology for histochemical analysis. Upon discovery of giant cells formation with polarizable foreign bodies, we performed a literature review regarding the Barricaid® device and its elements. Results: After two previous operations and three trials of conservative management, the presented patient underwent an L5/S1 TLIF with removal of her previously installed Barricaid® device. There were no signs of device instability/failure nor were there obvious signs of infection. Inflamed tissue proximal to the Barricaid® device was discovered, debrided, and sample sent to pathology. Removal of the Barricaid® device led to subsequent and durable relief of her symptoms. During review of this case, we discovered the polyethylene terephthalate (PET) weave used in the Barricaid® device is known to induce foreign body reactions, and this precise finding was seen in the majority of animal data submitted to the FDA for the device's acceptance. Conclusion: Given the constellation of this patient's symptoms, imaging, intraoperative, and pathology findings, previously published reports, and pre-approval data submitted to the FDA, we conclude that the inflammatory response to the PET weave in this patient's Barricaid® device was the ultimate cause of her continued neuropathy despite multiple prior surgical interventions.
- Subjects
FOREIGN body reaction; RETICULUM cell sarcoma; LITERATURE reviews; POLYETHYLENE terephthalate; NEUROPATHY; AUDITORY neuropathy; FOREIGN bodies
- Publication
European Spine Journal, 2024, Vol 33, Issue 7, p2840
- ISSN
0940-6719
- Publication type
Article
- DOI
10.1007/s00586-023-07910-2