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Altorfer FCS, Kelly MJ, Avrumova F, Zhu J, Abjornson C, Lebl DR. Reasons for Revision Surgery After Cervical Disk Arthroplasty Based on Medical Device Reports Maintained by the US Food and Drug Administration. Spine (Phila Pa 1976) 2024; 49:1417-1425. [PMID: 38819199 DOI: 10.1097/brs.0000000000005060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/20/2024] [Indexed: 06/01/2024]
Abstract
STUDY DESIGN Retrospective database review. OBJECTIVE The aim of this study was to analyze revisions of CDAs reported to the MAUDE database. SUMMARY OF BACKGROUND DATA Cervical disk arthroplasty (CDA) has emerged as a motion-preserving alternative to anterior cervical discectomy and fusion (ACDF) for degenerative cervical disease, demonstrating comparable outcomes. Despite the availability of variable CDA designs, there is limited data on the specific complications of individual CDAs. The Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database has been used to systematically report complications associated with CDAs. However, data on specific reasons for CDA revision remains scarce. The purpose of this study is to compare common complications associated with revision for different CDAs. METHODS The MAUDE database was queried from January 2005 to September 2023, including all nine FDA-approved CDAs. The full-text reports of each complication were categorized based on whether revision surgery was performed, the complications and the type of CDA collected and compared. RESULTS A total of 678 revisions for nine CDAs were reported: Mobi-C (239), M6 (167), Prodisc-C (88), Prestige (60), PCM (44), Bryan (35), Secure (23), Simplify (21), and Discover (1). The top three complications associated with revision were migration (23.5%), neck pain (15.5%), and heterotopic ossification (6.6%). The most common complications per device were migration for Mobi-C (26.4%), Prodisc-C (21.3%), Prestige (24.6%), PCM (84.1%), Bryan (48.6%), Secure (30.4%), and Discover (100%). For M6, the most common complications associated with revision surgery were osteolysis (18.6%) and neck pain (18.6%), while neck pain (23.8%) was the most common for the Simplify. CONCLUSIONS The MAUDE database highlights complications related to CDA revision in which the primary complications consistently include implant migration, neck pain, and heterotopic ossification, varying in their rerelvance depending on the CDA. LEVEL OF EVIDENCE Level II.
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Affiliation(s)
| | - Michael J Kelly
- Department of Spine Surgery, Hospital for Special Surgery, New York, NY
| | - Fedan Avrumova
- Department of Spine Surgery, Hospital for Special Surgery, New York, NY
| | - Jiaqi Zhu
- Biostatistics Core, Hospital for Special Surgery, New York, NY
| | - Celeste Abjornson
- Department of Spine Surgery, Hospital for Special Surgery, New York, NY
| | - Darren R Lebl
- Department of Spine Surgery, Hospital for Special Surgery, New York, NY
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Shafi K, Du JY, Blackburn CW, Kim HJ, Iyer S, Qureshi S, Marcus RE, Albert TJ. Trends in Indications and Contraindications for Cervical Disk Arthroplasty from 2009 to 2019. Clin Spine Surg 2024; 37:E283-E289. [PMID: 38446591 DOI: 10.1097/bsd.0000000000001589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 11/29/2023] [Indexed: 03/08/2024]
Abstract
STUDY DESIGN Cross-sectional study. OBJECTIVE Assess trends of indications and contraindications for the use of Cervical Disk Arthroplasty (CDA). SUMMARY OF BACKGROUND DATA As spine surgeons become more familiar with CDA, there have been expansions in indications. METHODS The Medicare Provider Analysis and Review Limited Data Sets for 2009, 2014, and 2019 were utilized. Patients undergoing elective CDA were included. Diagnosis for index surgery and "contraindications" as defined by original CDA Investigative Device Exemption (IDE) criteria were assessed. Variables were identified by the International Classification of Diseases (ICD)-9 or ICD-10 diagnosis and procedural codes. RESULTS A total of 1067 elective CDA patients were included. There were 230 patients in 2009, 300 patients in 2014, and 537 patients in 2019. The proportion of patients aged >65 increased from 35% to 51% ( P <0.001). Incidence of CDA for radiculopathy increased from 57% to 69% ( P <0.001), myelopathy increased from 23% to 78% ( P <0.001), and spondylosis without radiculopathy or myelopathy decreased from 19% to 3% ( P <0.001). There were increased incidences of ankylosing spondylitis (0.4% to 2.8%, P =0.007), long-term steroid use (1% to 2%, P =0.039), morbid obesity (2% to 6%, P =0.019), and osteoporosis (1% to 5%, P =0.014). The incidence of hybrid CDA and anterior cervical discectomy and fusion (ACDF) decreased from 28% to 23% ( P =0.007). CONCLUSION From 2009 to 2019, the number of CDA performed in older patients increased. An increase in the use of CDA for the treatment of myelopathy and radiculopathy and a decrease in the treatment of isolated cervical spondylosis was observed. The proportion of CDA performed in patients with original IDE trial "contraindications" increased. Further research into the efficacy of CDA for patients with contraindications is warranted.
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Affiliation(s)
- Karim Shafi
- Division of Spine Surgery, Hospital for Special Surgery, New York City, NY
| | - Jerry Y Du
- Division of Spine Surgery, Hospital for Special Surgery, New York City, NY
| | - Collin W Blackburn
- Department of Orthopedics, University Hospitals/Cleveland Medical Center, Cleveland, OH
| | - Han Jo Kim
- Division of Spine Surgery, Hospital for Special Surgery, New York City, NY
| | - Sravisht Iyer
- Division of Spine Surgery, Hospital for Special Surgery, New York City, NY
| | - Sheeraz Qureshi
- Division of Spine Surgery, Hospital for Special Surgery, New York City, NY
| | - Randall E Marcus
- Department of Orthopedics, University Hospitals/Cleveland Medical Center, Cleveland, OH
| | - Todd J Albert
- Division of Spine Surgery, Hospital for Special Surgery, New York City, NY
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Yao M, Wu T, Liu H, Huang K, He J, Chen S, Wang B. More anterior bone loss in middle vertebra after contiguous two-segment cervical disc arthroplasty. J Orthop Surg Res 2024; 19:234. [PMID: 38610023 PMCID: PMC11010387 DOI: 10.1186/s13018-024-04663-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/02/2024] [Indexed: 04/14/2024] Open
Abstract
BACKGROUND Contiguous two-segment cervical disc arthroplasty (CDA) is safe and effective, while post-operative radiographic change is poorly understood. We aimed to clarify the morphological change of the three vertebral bodies operated on. METHODS Patients admitted between 2015 and 2020 underwent contiguous two-level Prestige LP CDA were included. The follow-up was divided into immediate post-operation (≤ 1 week), early (≤ 6 months), and last follow-up (≥ 12 months). Clinical outcomes were measured by Japanese Orthopedic Association (JOA) score, visual analogue score (VAS), and neck disability index (NDI). Radiographic parameters on lateral radiographs included sagittal area, anterior-posterior diameters (superior, inferior endplate length, and waist length), and anterior and posterior heights. Sagittal parameters included disc angle, Cobb angle, range of motion, T1 slope, and C2-C7 sagittal vertical axis. Heterotopic ossification (HO) and anterior bone loss (ABL) were recorded. RESULTS 78 patients were included. Clinical outcomes significantly improved. Of the three operation-related vertebrae, only middle vertebra decreased significantly in sagittal area at early follow-up. The four endplates that directly meet implants experienced significant early loss in length. Sagittal parameters were kept within an acceptable range. Both segments had a higher class of HO at last follow-up. More ABL happened to middle vertebra. The incidence and degree of ABL were higher for the endplates on middle vertebra only at early follow-up. CONCLUSION Our findings indicated that after contiguous two-segment CDA, middle vertebra had a distinguishing morphological changing pattern that could be due to ABL, which deserves careful consideration before and during surgery.
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Affiliation(s)
- Minghe Yao
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan, 610041, China
| | - Tingkui Wu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan, 610041, China
| | - Hao Liu
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan, 610041, China
| | - Kangkang Huang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan, 610041, China
| | - Junbo He
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan, 610041, China
| | - Shihao Chen
- Department of Orthopedics, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan, 610041, China
| | - Beiyu Wang
- Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, 37 Guoxue Lane, Chengdu, Sichuan, 610041, China.
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Khachatryan A, Phillips FM, Lanman TH, Andersson GB, Jacobs JJ, Kurtz SM. Proposal for a classification system of radiographic bone changes after cervical disc replacement. J Orthop Surg Res 2024; 19:218. [PMID: 38566203 PMCID: PMC10988897 DOI: 10.1186/s13018-024-04679-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND The goal of this study is to propose a classification system with a common nomenclature for radiographic observations of periprosthetic bone changes following cTDR. METHODS Aided by serial plain radiographs from recent cTDR cases (34 patients; 44 devices), a panel of experts assembled for the purpose of creating a classification system to aid in reproducibly and accurately identifying bony changes and assessing cTDR radiographic appearance. Subdividing the superior and inferior vertebral bodies into 3 equal sections, observed bone loss such as endplate rounding, cystic erosion adjacent to the endplate, and cystic erosion not adjacent to the endplate, is recorded. Determining if bone loss is progressive, based on serial radiographs, and estimating severity of bone loss (measured by the percentage of end plate involved) is recorded. Additional relevant bony changes and device observations include radiolucent lines, heterotopic ossification, vertebral body olisthesis, loss of core implant height, and presence of device migration, and subsidence. RESULTS Serial radiographs from 19 patients (25 devices) implanted with a variety of cTDR designs were assessed by 6 investigators including clinicians and scientists experienced in cTDR or appendicular skeleton joint replacement. The overall agreement of assessments ranged from 49.9% (95% bootstrap confidence interval 45.1-73.1%) to 94.7% (95% CI 86.9-100.0%). There was reasonable agreement on the presence or absence of bone loss or radiolucencies (range: 58.4% (95% CI 51.5-82.7%) to 94.7% (95% CI 86.9-100.0%), as well as in the progression of radiolucent lines (82.9% (95% CI 74.4-96.5%)). CONCLUSIONS The novel classification system proposed demonstrated good concordance among experienced investigators in this field and represents a useful advancement for improving reporting in cTDR studies.
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Affiliation(s)
| | | | | | | | | | - Steven M Kurtz
- Implant Research Core, School of Biomedical Science, Engineering, and Health Systems, Drexel University, Philadelphia, PA, USA.
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Häckel S, Gaff J, Pabbruwe M, Celenza A, Kern M, Taylor P, Miles A, Cunningham G. Heterotopic ossification, osteolysis and implant failure following cervical total disc replacement with the M6-C™ artificial disc. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:1292-1299. [PMID: 38363365 DOI: 10.1007/s00586-024-08129-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 12/14/2023] [Accepted: 01/01/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION A recent study reported a 34% mid-term revision rate after M6-C™ cervical total disc replacement (CTDR) for wear-related osteolysis. Here, we aim to investigate the prevalence, risk factors, and radiographic characteristics of periprosthetic bony changes and implant failure of the M6-C™ artificial disc. METHODS We retrospectively analysed radiographic (conventional X-ray, CT scan) and clinical outcomes (EQ-5D-5L, Neck Disability Index (NDI), and Visual Analog Scale (VAS) for neck and arm pain) data collected during routine follow-up of patients who underwent CTDR with the M6-C™ between 2011 and 2015. RESULTS In total, 85 patients underwent CTDR with the M6-C™. Follow-up data were available for 43 patients (54% female, mean age 44 years) with 50 implants and a mean follow-up of 8.1 years (6.5-11 years). Implant failure with the presence of severe osteolysis was identified in 5 (12%) patients who were all male (p = 0.016) and implanted at the C5/6 level (p = 0.11). All failed implants required revision surgery. The overall prevalence of osteolysis was 44% (22/50 implants) and 34% (17/50 implants) for significant heterotopic ossification. Patients with high-grade osteolysis showed higher VAS arm pain (p = 0.05) and lower EQ-5D-VAS health VAS (p = 0.03). CONCLUSION We report a lower reoperation rate for failed M6-C™ implants than previously published, but confirmed that osteolysis and heterotopic ossification are common following CTDR with the M6-C™ and may be asymptomatic. Therefore, we strongly recommend ongoing clinical and radiographic monitoring after CTDR with the M6-C™, particularly for male patients implanted at the C5/6 level.
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Affiliation(s)
- Sonja Häckel
- Neurospine Institute, Murdoch, Australia
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital Bern, University Bern, Bern, Switzerland
| | - Jessica Gaff
- Neurospine Institute, Murdoch, Australia.
- Curtin Medical School, Curtin University, Bentley, Australia.
| | - Moreica Pabbruwe
- Department of Medical Engineering and Physics, Centre for Implant Technology and Retrieval Analysis, Royal Perth Hospital, Perth, Australia
| | | | - Michael Kern
- Neurospine Institute, Murdoch, Australia
- Department of Neurosurgery, St. John of God Hospital, Murdoch, Australia
| | - Paul Taylor
- Neurospine Institute, Murdoch, Australia
- Department of Orthopaedic Surgery, St. John of God Hospital, Murdoch, Australia
- Department of Orthopaedic Surgery, Mount Hospital, Perth, Australia
| | - Andrew Miles
- Neurospine Institute, Murdoch, Australia
- Department of Neurosurgery, St. John of God Hospital, Murdoch, Australia
| | - Greg Cunningham
- Neurospine Institute, Murdoch, Australia
- Curtin Medical School, Curtin University, Bentley, Australia
- Department of Orthopaedic Surgery, St. John of God Hospital, Murdoch, Australia
- Department of Orthopaedic Surgery, Mount Hospital, Perth, Australia
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Phillips FM, Coric D, Sasso R, Lanman T, Lavelle W, Lauryssen C, Albert T, Cammisa F, Milam RA. Prospective, multicenter clinical trial comparing the M6-C compressible cervical disc with anterior cervical discectomy and fusion for the treatment of single-level degenerative cervical radiculopathy: 5-year results of an FDA investigational device exemption study. Spine J 2024; 24:219-230. [PMID: 37951477 DOI: 10.1016/j.spinee.2023.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/18/2023] [Accepted: 10/30/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND CONTEXT Various total disc replacement (TDR) designs have been compared to anterior cervical discectomy and fusion (ACDF) with favorable short and long-term outcomes in FDA-approved investigational device exemption (IDE) trials. The unique design of M6-C, with a compressible viscoelastic nuclear core and an annular structure, has previously demonstrated favorable clinical outcomes through 24 months. PURPOSE To evaluate the long-term safety and effectiveness of the M6-C compressible artificial cervical disc and compare to ACDF at 5 years. STUDY DESIGN Prospective, multicenter, concurrently and historically controlled, FDA-approved IDE clinical trial. PATIENT SAMPLE Subjects with one-level symptomatic degenerative cervical radiculopathy were enrolled and received M6-C (n=160) or ACDF (n=189) treatment as part of the IDE study. Safety outcomes were evaluated at 5 years for all subjects. The primary effectiveness endpoint was available at 5 years for 113 M6-C subjects and 106 ACDF controls. OUTCOME MEASURES The primary endpoint of this analysis was composite clinical success (CCS) at 60 months. Secondary endpoints were function and pain (neck disability index, VAS), physical quality of life (SF-36, SF-12), safety, neurologic, and radiographic assessments. METHODS Propensity score subclassification was used to control for selection bias and match baseline covariates of the control group to the M6-C subjects. Sixty-month CCS rates were estimated for each treatment group using a generalized linear model controlling for propensity score. RESULTS At 5 years postoperatively, the M6-C treatment resulted in 82.3% CCS while the ACDF group showed 67.0% CCS (superiority p=.013). Secondary endpoints indicated that significantly more M6-C subjects achieved VAS neck and arm pain improvements and showed maintained or improved physical functioning on quality-of-life measures compared to baseline assessments. The M6-C group-maintained flexion-extension motion, with significantly greater increases from baseline disc height and disc angle than observed in the control group. The rates of M6-C subsequent surgical interventions (SSI; 3.1%) and definitely device- or procedure-related serious adverse events (SAE failure; 3.1%) were similar to ACDF rates (SSI=5.3%, SAE failure=4.8%; p>.05 for both). CONCLUSIONS Subjects treated with the M6-C artificial disc demonstrated superior 5-year achievement of clinical success when compared to ACDF controls. In addition, significantly more subjects in the M6-C group showed improved pain and physical functioning scores than observed in ACDF subjects, with no difference in reoperation rates or safety outcomes.
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Affiliation(s)
- Frank M Phillips
- Midwest Orthopaedics at Rush University Medical Center, 1611 W Harrison St # 300, Chicago, IL 60612, USA.
| | - Domagoj Coric
- Carolina Neurosurgery & Spine Associates, Atruim Health Musculoskeletal Institute, 225 Baldwin Ave, Charlotte, NC 28204, USA
| | - Rick Sasso
- Indiana Spine Group. 13225 N Meridian St, Carmel, IN 46032, USA
| | - Todd Lanman
- Lanman Spinal Neurosurgery, 450 N Roxbury Dr, Beverly Hills, CA 90210, USA
| | - William Lavelle
- Upstate Bone and Joint Center, 6620 Fly Rd, East Syracuse, NY 13057, USA
| | - Carl Lauryssen
- Central Texas Brain and Spine, PLLC, 2217 Park Bend Dr, Unit 400, Austin, TX 78758, USA
| | - Todd Albert
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
| | - Frank Cammisa
- Hospital for Special Surgery, 535 East 70th St, New York, NY 10021, USA
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Roth SG, Robles Ortiz MJ, Vulapalli M, Riew KD. Revision Strategies for Cervical Disc Arthroplasty. Clin Spine Surg 2023; 36:411-418. [PMID: 37752631 DOI: 10.1097/bsd.0000000000001542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023]
Abstract
STUDY DESIGN Narrative review. OBJECTIVE To review indications and strategies for revision of cervical disc arthroplasty (CDA). SUMMARY OF BACKGROUND DATA No data were generated as part of this review. METHODS A narrative review of the literature was performed. RESULTS No results were generated as part of this review. CONCLUSIONS CDA is a proven, motion-sparing surgical option for the treatment of myelopathy or radiculopathy secondary to cervical degenerative disc disease. As is the case with any operation, a small percentage of CDA will require revision, which can be a technically demanding endeavor. Here we review available revision strategies and associated indications, a thorough understanding of which will aid the surgeon in finely tailoring their approach to varying presentations.
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Affiliation(s)
- Steven G Roth
- Department of Neurological Surgery, Weill Cornell Medical Center
- Department of Orthopedic Surgery, Daniel and Jane Och Spine Hospital, Columbia University Medical Center, New York, NY
| | | | - Meghana Vulapalli
- Department of Orthopedic Surgery, Daniel and Jane Och Spine Hospital, Columbia University Medical Center, New York, NY
| | - K Daniel Riew
- Department of Neurological Surgery, Weill Cornell Medical Center
- Department of Orthopedic Surgery, Daniel and Jane Och Spine Hospital, Columbia University Medical Center, New York, NY
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8
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Nguyen AQ, Credille K, Saifi C. Short-term and Long-term Complications of Cervical Disc Arthroplasty. Clin Spine Surg 2023; 36:404-410. [PMID: 37752635 DOI: 10.1097/bsd.0000000000001541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/28/2023]
Abstract
STUDY DESIGN A narrative review. OBJECTIVE This review discusses the short and long-term complications associated with cervical disc arthroplasty (CDA). SUMMARY OF BACKGROUND DATA CDA is a safe and effective motion-sparing alternative to fusion for the treatment of cervical disc pathology in patients with cervical radiculopathy or myelopathy. Although CDA offers advantages over fusion within a narrower set of indications, it introduces new technical challenges and potential complications. METHODS A systematic search of several large databases, including Cochrane Central, PubMed, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry, was conducted from January 2005 to August 2023 to identify published studies and clinical trials evaluating cervical disc replacement complications and outcomes. RESULTS Short-term complications are primarily related to surgical approach and include dysphagia reported as high as ~70%, laryngeal nerve injury ~0%-1.25%, Horner syndrome ~0.06%, hematoma ~0.01%, gross device extrusion ~0.3%, whereas long-term complications include adjacent segment disease reported at ~3.8%, osteolysis ~44%-64%, heterotopic ossification ~7.3%-69.2%, implant failure ~3.3%-3.7%, and implant wear, which varies depending on design. CONCLUSIONS Approaches for mitigating complications broadly include meticulous dissection, intraoperative techniques, and diligent postoperative follow-up. This review emphasizes the need for a comprehensive understanding and management of complications to enhance the safety, reproducibility, and success of CDA. As CDA continues to evolve, there remains a critical need for ongoing research to delve deeper into evaluating risk for complications and long-term patient outcomes.
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Affiliation(s)
- Austin Q Nguyen
- Department of Orthopedics and Sports Medicine, Houston Methodist Hospital, Houston, TX
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Du JY, Gonzalez GA, Albert TJ, Rhee JM, Riew KD, Vaccaro AR, Harrop JS. Past, Present, and Future of Cervical Disc Arthroplasty: Insights From Presidents of the Cervical Spine Research Society. Clin Spine Surg 2023; 36:331-334. [PMID: 37735760 DOI: 10.1097/bsd.0000000000001536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 08/10/2023] [Indexed: 09/23/2023]
Affiliation(s)
- Jerry Y Du
- Spine Surgery Division, Hospital for Special Surgery, New York City, NY
| | - Glenn A Gonzalez
- Department of Neurosurgery, Thomas Jefferson University School of Medicine, Philadelphia, PA
| | - Todd J Albert
- Spine Surgery Division, Hospital for Special Surgery, New York City, NY
| | - John M Rhee
- Department of Orthopedics, Emory University School of Medicine, Atlanta, GA
| | - K Daniel Riew
- Department of Neurosurgery, NewYork-Presbyterian Hospital/Weill Cornell Medical Center, New York City, NY
| | - Alexander R Vaccaro
- Rothman Orthopaedic Institute, Thomas Jefferson University School of Medicine, Philadelphia, PA
| | - James S Harrop
- Department of Neurosurgery, Thomas Jefferson University School of Medicine, Philadelphia, PA
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10
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Choi MK, Lee JH. Cervical Myelopathy Induced by Posterior Vertebral Body Osteolysis after Cervical Disc Arthroplasty. J Korean Neurosurg Soc 2023; 66:591-597. [PMID: 36950776 PMCID: PMC10483154 DOI: 10.3340/jkns.2022.0190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/22/2022] [Accepted: 01/04/2023] [Indexed: 03/24/2023] Open
Abstract
Cervical disc arthroplasty (CDA) has become more widespread and diverges from the conventional technique used in anterior cervical fusion for cervical degenerative disc disease. As arthroplasty has become a popular treatment option, few complications have been reported in the literature. These include subsidence, expulsion, posterior avulsion fractures, heterotopic ossification, and osteolysis. One of the critical complications is osteolysis, but current studies on this subject are limited in terms of not elucidating the incidence, etiology, and consequences. The authors present two cases, who presented with clinical signs of gradually worsening myelopathy induced by posterior vertebral body osteolysis, 2 years after CDA. Subsequently, the patient underwent posterior decompression and fusion without prosthesis removal. Postoperatively, the clinical symptoms gradually resolved, with no severe deficits. The present rare cases highlight the osteolysis that occurs after CDA, which can cause cervical myelopathy, and suggest spine surgeons to be alert to this fatal complication.
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Affiliation(s)
- Man Kyu Choi
- Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
| | - Jun Ho Lee
- Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea
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11
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Ko CC, Feng BK, Kuo YH, Kuo CH, Tu TH, Chang CC, Cheng H, Huang WC, Wu JC. Incidence and Risk Factor of Implant Dislocation After Cervical Disk Arthroplasty: A Retrospective Cohort Analysis of 756 Patients. Neurosurgery 2023; 93:330-338. [PMID: 36805569 DOI: 10.1227/neu.0000000000002413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 12/16/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Implant dislocation after cervical disk arthroplasty (CDA) is obviously a critical complication, but no information about the incidence and associated risk factor has been reported. OBJECTIVE To investigate the incidence and risk factor of implant dislocation after CDA by a retrospective cohort analysis. METHODS A retrospective review of a consecutive series of CDA performed between January 2009 and March 2021 at a single institution was conducted. Analyses of chart records and radiological data established the incidence and associated risk factor of implant dislocation after CDA. A Kaplan-Meier survival estimation of implant survival was performed. RESULTS A total of 756 consecutive patients were included in this analysis. Five patients (0.7%) had a migration and even dropout of the artificial disk. The overall cumulative survival rate of the implant reached approximately 99.3% of the 756 patients. Preoperative kyphosis was significantly related to implant dislocation ( P = .016), with an odds ratio of 15.013. CONCLUSION The incidence of implant dislocation after CDA is as low as 0.7% or 5/756 patients. Preoperative kyphosis significantly increases the risk of postoperative implant dislocation by a factor of 15. The migrating implants could be revealed on radiographs as early as 0.9 to 1.4 months postoperatively and were revised to anterior cervical diskectomy and fusion within half a year. No new event of implant dislocation occurred half a year postoperatively. The overall cumulative survival rate of the implant reached 99.3% of the 756 patients. In conclusion, CDA remains a safe and reliable procedure.
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Affiliation(s)
- Chin-Chu Ko
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Bo-Kai Feng
- Department of Obstetrics and Gynecology, Far Eastern Memorial Hospital, New Taipei, Taiwan
| | - Yi-Hsuan Kuo
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Biomedical Informatics, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chao-Hung Kuo
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Biomedical Engineering, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tsung-Hsi Tu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Chang Chang
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Biomedical Engineering, School of Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Henrich Cheng
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Wen-Cheng Huang
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jau-Ching Wu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Institute of Pharmacology, National Yang Ming Chiao Tung University, Taipei, Taiwan
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12
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Anterior Bone Loss after Cervical Baguera C Disc versus Bryan Disc Arthroplasty. BIOMED RESEARCH INTERNATIONAL 2023; 2023:8010223. [PMID: 36794256 PMCID: PMC9925247 DOI: 10.1155/2023/8010223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/07/2022] [Accepted: 01/15/2023] [Indexed: 02/08/2023]
Abstract
Objectives The objectives of this study were to identify the risk factors and incidence of anterior bone loss (ABL) after Baguera C cervical disc arthroplasty (CDA) and identify whether design differences in artificial discs affect ABL. Methods In this retrospective radiological review of patients who underwent single-level Baguera C CDA in a medical center, the extent of ABL and the following radiological parameters were recorded: global and segmental alignment angle, lordotic angle (or functional spinal unit angle), shell angle, global range of motion (ROM), and ROM of the index level. ABL at the index level was grade 0-2. Grade 0 was defined as no remodeling, grade 1 as spur disappearance or mild change in body contour, and grade 2 as obvious bone regression with Baguera C Disc exposure. Results Combining grade 1 and grade 2, ABL was found in 56 upper adjacent vertebrae and 52 lower adjacent vertebrae of the 77 patients. Only 18 patients (23.4%) had no ABL. Shell angle differed significantly between ABL grades of both the upper and lower adjacent level: 0.0° in grade 0 and 1 ABL vs. 2.0° in grade 2 ABL of the upper adjacent level (p < 0.05); and 0.0° in grade 0 and 1 ABL vs. 3.5° in grade 2 ABL of the lower adjacent level (p < 0.05). A female predominance of ABL was found. Hybrid surgery and artificial disc size were also related to ABL. Conclusions ABL is more common in Baguera C Disc arthroplasty than Bryan Disc arthroplasty. Larger shell angle was related to ABL after CDA with Baguera C Discs, which may indicate that shell angle is pivotal in determining the incidence of ABL after CDA. Females had more ABL with Baguera C Disc arthroplasty; this might be related to shorter endplate lengths as well as a smaller endplate-implant mismatch.
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Tao R, Wu JQ, Luo JW, Hong L, Zhou CH, Cheng GY, Qin CH. Antibiotic-impregnated calcium sulfate for the treatment of pediatric hematogenous osteomyelitis. BMC Pediatr 2022; 22:732. [PMID: 36564727 PMCID: PMC9783740 DOI: 10.1186/s12887-022-03791-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Antibiotic-impregnated calcium sulfate has excellent curative efficacy in chronic osteomyelitis. However, its curative efficacy in pediatric hematogenous osteomyelitis has not been sufficiently studied. The purpose of this study was to evaluate the curative effects of antibiotic-impregnated calcium sulfate in the treatment of pediatric hematogenous osteomyelitis. METHODS Overall, twenty-one pediatric patients with hematogenous osteomyelitis treated at our hospital between 2013 and 2018 were included for assessment. The clinical history, clinical manifestation, infection recurrence rate, sinus leakage, incision leakage, pathological fractures, bone growth and surgical procedures were analyzed. RESULTS The infection recurrence rate was 0% (0/21) at a minimum of 31 months (range 31 to 91 months) of follow-up. Postoperative incision leakage was found in one pediatric patient. Osteolysis was found in one pediatric patient. Acceleration of bone growth occurred in one pediatric patient. Retardation of bone growth occurred in one pediatric patient. Genu valgus deformity occurred in one pediatric patient. CONCLUSIONS Although noninfectious complications occurred, the curative effect of antibiotic-impregnated calcium sulfate in pediatric hematogenous osteomyelitis was satisfactory.
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Affiliation(s)
- Rui Tao
- grid.284723.80000 0000 8877 7471Department of Orthopaedics, Southern Medical University Zengcheng Branch of Nanfang Hospital, No. 28 Chuangxin Avenue Yongning Street, Zengcheng District Guangzhou, 511340 People’s Republic of China
| | - Jian-qun Wu
- grid.263817.90000 0004 1773 1790Department of Bone and Joint, School ofMedicine, The First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, 518055 People’s Republic of China
| | - Ji-wei Luo
- grid.284723.80000 0000 8877 7471Department of Orthopaedics and Traumatology, Southern Medical University Nanfang Hospital, No. 1838, Guangzhou Ave. North, Guangzhou, Guangdong 510515 People’s Republic of China
| | - Liang Hong
- grid.284723.80000 0000 8877 7471Department of Orthopaedics, Southern Medical University Zengcheng Branch of Nanfang Hospital, No. 28 Chuangxin Avenue Yongning Street, Zengcheng District Guangzhou, 511340 People’s Republic of China
| | - Chun-hao Zhou
- grid.284723.80000 0000 8877 7471Department of Orthopaedics and Traumatology, Southern Medical University Nanfang Hospital, No. 1838, Guangzhou Ave. North, Guangzhou, Guangdong 510515 People’s Republic of China
| | - Guo-yun Cheng
- Department of Orthopaedics and Traumatology, Second Clinical Medical School, Guangdong Second Provincial General Hospital, Southern Medical University, Guangzhou, 510317 People’s Republic of China
| | - Cheng-he Qin
- grid.284723.80000 0000 8877 7471Department of Orthopaedics and Traumatology, Southern Medical University Nanfang Hospital, No. 1838, Guangzhou Ave. North, Guangzhou, Guangdong 510515 People’s Republic of China
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Wang X, Lin Y, Wang Q, Gao L, Feng F. A Bibliometric Analysis of the Top 100 Cited Articles in Anterior Cervical Discectomy and Fusion. J Pain Res 2022; 15:3137-3156. [PMID: 36311292 PMCID: PMC9604433 DOI: 10.2147/jpr.s375720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 09/23/2022] [Indexed: 11/23/2022] Open
Abstract
Study design A bibliometric analysis. Objective To identify and analyze the top 100 cited articles in anterior cervical discectomy and fusion. Summary of Background Data Anterior cervical discectomy and fusion (ACDF) is one of the most routine surgical procedures in spine surgery. Many surgeons and academics have researched ACDF thoroughly and published numerous articles. However, there is no relevant bibliometric analysis. Therefore, our study aims to identify and analyze the top 100 cited articles in ACDF to identify the research trends. Methods We searched the Web of Science (WOS) Core Collection database with restrictions and identified the top 100 cited publications in ACDF for analysis. Results The citation counts of the top 100 cited publications ranged from 37 to 361 (mean 67.42). All studies were published between 2008 and 2019, with 2013 and 2015 the most prolific years. The journals Spine and Journal of Neurosurgery-Spine provided the majority of the articles. Overall, the 100 articles came from 12 countries, with the United States being the top producer, followed by China and South Korea. The most frequent keywords were "spine", "anterior cervical discectomy and fusion", "interbody fusion", 'arthrodesis', "follow-up", "decompression", and "ACDF". Conclusion ACDF has been regarded as a classical gold standard in anterior cervical surgery, and the emergence of new surgical procedures has not affected its status. Cervical disc arthroplasty still needs further research and development. As the first bibliometric analysis of ACDF, this bibliometric study is meant to provide guidance for clinicians and scholars to research the development trend of this field.
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Affiliation(s)
- Xun Wang
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang310053, People’s Republic of China
| | - Yanze Lin
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang310053, People’s Republic of China
| | - Qiongtai Wang
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang310053, People’s Republic of China
| | - Liqing Gao
- Zhejiang Chinese Medical University, Hangzhou, Zhejiang310053, People’s Republic of China
| | - Fabo Feng
- Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China,Correspondence: Fabo Feng, Center for Plastic & Reconstructive Surgery, Department of Orthopedics, Zhejiang Provincial People’s Hospital (Affiliated People’s Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, 310014, People’s Republic of China, Email
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Siasios I, Tsoleka K, Samara E, Birbilis T. Letter to the Editor Regarding "Anterior Bone Loss in Cervical Disk Arthroplasty Correlates with Increased Cervical Lordosis". World Neurosurg 2022; 166:288-289. [PMID: 36192852 DOI: 10.1016/j.wneu.2022.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 07/04/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Ioannis Siasios
- Department of Neurosurgery, General Hospital of Papageorgiou, Thessaloniki, Greece; Department of Neurosurgery, General University Hospital of Alexandroupolis, Alexandroupoli, Greece.
| | - Kalliopi Tsoleka
- Department of Neurosurgery, General Hospital of Papageorgiou, Thessaloniki, Greece
| | - Ethymia Samara
- Department of Neurology, General Hospital of Papageorgiou, Thessaloniki, Greece
| | - Theodosis Birbilis
- Department of Neurosurgery, General University Hospital of Alexandroupolis, Alexandroupoli, Greece
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16
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Wellington IJ, Kia C, Coskun E, Torre BB, Antonacci CL, Mancini MR, Connors JP, Esmende SM, Makanji HS. Cervical and Lumbar Disc Arthroplasty: A Review of Current Implant Design and Outcomes. Bioengineering (Basel) 2022; 9:bioengineering9050227. [PMID: 35621505 PMCID: PMC9137579 DOI: 10.3390/bioengineering9050227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/16/2022] Open
Abstract
While spinal disc pathology has traditionally been treated using fusion-based procedures, recent interest in motion-preserving disc arthroplasties has grown. Traditional spinal fusion is associated with loss of motion, alteration of native spine kinematics, and increased risks of adjacent segment disease. The motion conferred by disc arthroplasty is believed to combat these complications. While the first implant designs resulted in poor patient outcomes, recent advances in implant design and technology have shown promising radiographic and clinical outcomes when compared with traditional fusion. These results have led to a rapid increase in the utilization of disc arthroplasty, with rates of cervical arthroplasty nearly tripling over the course of 7 years. The purpose of this review was to discuss the evolution of implant design, the current implant designs utilized, and their associated outcomes. Although disc arthroplasty shows significant promise in addressing some of the drawbacks associated with fusion, it is not without its own risks. Osteolysis, implant migration, and the development of heterotopic ossification have all been associated with disc arthroplasty. As interest in these procedures grows, so does the interest in developing improved implant designs aimed at decreasing these adverse outcomes. Though they are still relatively new, cervical and lumbar disc arthroplasty are likely to become foundational methodologies for the treatment of disc pathology.
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Affiliation(s)
- Ian J. Wellington
- Department of Orthopaedics, University of Connecticut, Farmington, CT 06032, USA; (I.J.W.); (E.C.); (B.B.T.); (C.L.A.); (M.R.M.); (J.P.C.)
| | - Cameron Kia
- Department of Orthopaedics, University of Connecticut, Farmington, CT 06032, USA; (I.J.W.); (E.C.); (B.B.T.); (C.L.A.); (M.R.M.); (J.P.C.)
- Correspondence:
| | - Ergin Coskun
- Department of Orthopaedics, University of Connecticut, Farmington, CT 06032, USA; (I.J.W.); (E.C.); (B.B.T.); (C.L.A.); (M.R.M.); (J.P.C.)
| | - Barrett B. Torre
- Department of Orthopaedics, University of Connecticut, Farmington, CT 06032, USA; (I.J.W.); (E.C.); (B.B.T.); (C.L.A.); (M.R.M.); (J.P.C.)
| | - Christopher L. Antonacci
- Department of Orthopaedics, University of Connecticut, Farmington, CT 06032, USA; (I.J.W.); (E.C.); (B.B.T.); (C.L.A.); (M.R.M.); (J.P.C.)
| | - Michael R. Mancini
- Department of Orthopaedics, University of Connecticut, Farmington, CT 06032, USA; (I.J.W.); (E.C.); (B.B.T.); (C.L.A.); (M.R.M.); (J.P.C.)
| | - John P. Connors
- Department of Orthopaedics, University of Connecticut, Farmington, CT 06032, USA; (I.J.W.); (E.C.); (B.B.T.); (C.L.A.); (M.R.M.); (J.P.C.)
| | - Sean M. Esmende
- Department of Orthopedics, Hartford Healthcare, Hartford, CT 06106, USA; (S.M.E.); (H.S.M.)
| | - Heeren S. Makanji
- Department of Orthopedics, Hartford Healthcare, Hartford, CT 06106, USA; (S.M.E.); (H.S.M.)
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The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2022; 31:830-842. [PMID: 34999945 DOI: 10.1007/s00586-021-07092-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Periprosthetic bone loss is a common observation following arthroplasty. Recognizing and understanding the nature of bone loss is vital as it determines the subsequent performance of the device and the overall outcome. Despite its significance, the term "bone loss" is often misused to describe inflammatory osteolysis, a complication with vastly different clinical outcomes and treatment plans. Therefore, the goal of this review was to report major findings related to vertebral radiographic bone changes around cervical disc replacements, mitigate discrepancies in clinical reports by introducing uniform terminology to the field, and establish a precedence that can be used to identify the important nuances between these distinct complications. METHODS A systematic review of the literature was conducted following PRISMA guidelines, using the keywords "cervical," "disc replacement," "osteolysis," "bone loss," "radiograph," and "complications." A total of 23 articles met the inclusion criteria with the majority being retrospective or case reports. RESULTS Fourteen studies reported periprosthetic osteolysis in a total of 46 patients with onset ranging from 15-96 months after the index procedure. Reported causes included: metal hypersensitivity, infection, mechanical failure, and wear debris. Osteolysis was generally progressive and led to reoperation. Nine articles reported non-inflammatory bone loss in 527 patients (52.5%), typically within 3-6 months following implantation. The reported causes included: micromotion, stress shielding, and interrupted blood supply. With one exception, bone loss was reported to be non-progressive and had no effect on clinical outcome measures. CONCLUSIONS Non-progressive, early onset bone loss is a common finding after CDA and typically does not affect the reported short-term pain scores or lead to early revision. By contrast, osteolysis was less common, presenting more than a year post-operative and often accompanied by additional complications, leading to revision surgery. A greater understanding of the clinical significance is limited by the lack of long-term studies, inconsistent terminology, and infrequent use of histology and explant analyses. Uniform reporting and adoption of consistent terminology can mitigate some of these limitations. Executing these actionable items is critical to assess device performance and the risk of revision. LEVEL OF EVIDENCE IV Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.
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Shin JJ, Kim KR, Son DW, Shin DA, Yi S, Kim KN, Yoon DH, Ha Y, Riew KD. Cervical disc arthroplasty: What we know in 2020 and a literature review. J Orthop Surg (Hong Kong) 2021; 29:23094990211006934. [PMID: 34581615 DOI: 10.1177/23094990211006934] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Cervical disc arthroplasty (CDA) is a safe and effective option to improve clinical outcomes (e.g., NDI, VAS, and JOA) in degenerative cervical disc disease and compressive myelopathy. CDA's two main purported benefits have been that it maintains physiologic motion and thereby minimizes the biomechanical stresses placed on adjacent segments as compared to an ACDF. CDA might reduce the degeneration of adjacent segments, and the need for adjacent-level surgery. Reoperation rates of CDA have been reported to range from 1.8% to 5.4%, with a minimum 5-year follow-up. As the number of CDA procedures performed continues to increase, the need for revision surgery is also likely to increase. When performed skillfully in appropriate patients, CDA is an effective surgical technique to optimize clinical outcomes and radiological results. This review may assist surgical decision-making and enable a more effective and safer implementation of cervical arthroplasty for cervical degenerative disease.
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Affiliation(s)
- Jun Jae Shin
- Department of Neurosurgery, Yongin Severance Hospital, 37991Yonsei University School of Medicine, Yongin, Korea
| | - Kwang-Ryeol Kim
- Department of Neurosurgery, International St Mary's Hospital, 54671Catholic Kwandong University, College of Medicine, Incheon, Korea
| | - Dong Wuk Son
- Department of Neurosurgery, 194197Pusan National University Yangsan Hospital, School of Medicine, Yangsan, Korea
| | - Dong Ah Shin
- Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, 37991Yonsei University College of Medicine, Seoul, Korea
| | - Seong Yi
- Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, 37991Yonsei University College of Medicine, Seoul, Korea
| | - Keung-Nyun Kim
- Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, 37991Yonsei University College of Medicine, Seoul, Korea
| | - Do-Heum Yoon
- Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, 37991Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Ha
- Department of Neurosurgery, Spine and Spinal Cord Institute, Severance Hospital, 37991Yonsei University College of Medicine, Seoul, Korea.,POSTECH Biotech Center, Pohang University of Science and Technology, Pohang, Gyeongbuk, Korea
| | - K Daniel Riew
- Department of Orthopedic Surgery, 5798Columbia University College of Physicians and Surgeons, New York, NY, USA.,Department of Neurological Surgery, Weill Cornell Medical College, Cornell University, New York, NY, USA
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19
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Letter to the Editor concerning "Osteolysis after cervical disc arthroplasty" by Joaquim AF, et al. (Eur Spine J; [2020]: doi: 10.1007/s00586-020-06,578-2). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 29:3248. [PMID: 32975631 DOI: 10.1007/s00586-020-06606-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 09/04/2020] [Accepted: 09/15/2020] [Indexed: 02/05/2023]
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