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Table 2 Imaging guidelines after lumbar total disc replacement with regard to implant alloy

From: Spine imaging after lumbar disc replacement: pitfalls and current recommendations

Complication/Alloy Titanium Stainless steel (CoCr)
Metallosis/PE wear loosening Plain x-ray, scintigraphy, PET-CT Plain x-ray, scintigraphy, PET-CT
Implant failure/fracture Plain x-ray, CT Plain x-ray, CT
Implant/Core dislocation Plain x-ray, CT Plain x-ray, CT
Infection MR, PET-CT, radiolabelled white blood cell scintigraphy PET-CT, radiolabelled white blood cell scintigraphy
Late facet degeneration/secondary stenosis MR, CT Myelography, CT
Implant malpositioning Plain x-ray, CT Plain x-ray, CT
Implant subsidence Plain x-ray, CT Plain x-ray, CT
Segmental fusion CT, dynamic plain x-ray CT, dynamic plain x-ray
  1. First-line diagnostics appear first.