Long-term tissue response to a metal device is described here. The components of a spinal fixation device were removed 6 years after implantation, following the need for revision surgery after a fall. Scanning electron microscopy (SEM) revealed changes in surface topography of the metal. Examination of the adjacent tissue showed a chronic inflammatory response with occasional metal debris. Immunohistochemistry identified the predominant macrophages and abundant neovascularization. The presence of macrophages in tissues adjacent to the implants, in an otherwise asymptomatic person, is noteworthy.
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