Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Cervical Myelopathy Induced by Posterior Vertebral Body Osteolysis after Cervical Disc Arthroplasty

  • Man Kyu Choi (Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine) ;
  • Jun Ho Lee (Department of Neurosurgery, Kyung Hee University Hospital, Kyung Hee University College of Medicine)
  • Received : 2022.08.22
  • Accepted : 2023.01.04
  • Published : 2023.09.01
Download PDF
⟨ Previous Next ⟩

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.

Keywords

References

  1. Chang PY, Wu JC, Mayo BC, Massel DH, Wang MY : Heterotopic ossification in cervical disc arthroplasty. Contemp Spine Surg 18 : 1-5, 2017 https://doi.org/10.1097/01.CSS.0000516127.25832.59
  2. Chen TY, Chen WH, Tzeng CY, Huang CW, Yang CC, Chen HT, et al. : Anterior bone loss after cervical Bryan disc arthroplasty: insight into the biomechanics following total disc replacement. Spine J 20 : 1211-1218, 2020 https://doi.org/10.1016/j.spinee.2020.04.017
  3. Gao F, Mao T, Sun W, Guo W, Wang Y, Li Z, et al. : An updated meta-analysis comparing artificial cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) for the treatment of cervical degenerative disc disease (CDDD). Spine (Phila Pa 1976) 40 : 1816-1823, 2015 https://doi.org/10.1097/BRS.0000000000001138
  4. Gawkrodger DJ : Metal sensitivities and orthopaedic implants revisited: the potential for metal allergy with the new metal-on-metal joint prostheses. Br J Dermatol 148 : 1089-1093, 2003 https://doi.org/10.1046/j.1365-2133.2003.05404.x
  5. Granchi D, Cenni E, Giunti A, Baldini N : Metal hypersensitivity testing in patients undergoing joint replacement: a systematic review. J Bone Joint Surg Br 94 : 1126-1134, 2012 https://doi.org/10.1302/0301-620X.94B8.28135
  6. Hacker FM, Babcock RM, Hacker RJ : Very late complications of cervical arthroplasty: results of 2 controlled randomized prospective studies from a single investigator site. Spine (Phila Pa 1976) 38 : 2223-2226, 2013 https://doi.org/10.1097/BRS.0000000000000060
  7. Hisey MS, Zigler JE, Jackson R, Nunley PD, Bae HW, Kim KD, et al. : Prospective, randomized comparison of one-level mobi-C cervical total disc replacement vs. anterior cervical discectomy and fusion: results at 5-year follow-up. Int J Spine Surg 10 : 10, 2016
  8. Hsu JE, Bumgarner RE, Matsen FA 3rd : Propionibacterium in shoulder arthroplasty: what we think we know today. J Bone Joint Surg Am 98 : 597-606, 2016 https://doi.org/10.2106/JBJS.15.00568
  9. Joaquim AF, Lee NJ, Lehman RA Jr, Tumialan LM, Riew KD : Osteolysis after cervical disc arthroplasty. Eur Spine J 29 : 2723-2733, 2020 https://doi.org/10.1007/s00586-020-06578-2
  10. Kieser DC, Cawley DT, Fujishiro T, Mazas S, Boissiere L, Obeid I, et al. : Risk factors for anterior bone loss in cervical disc arthroplasty. J Neurosurg Spine 29 : 123-129, 2018 https://doi.org/10.3171/2018.1.SPINE171018
  11. Kieser DC, Cawley DT, Fujishiro T, Tavolaro C, Mazas S, Boissiere L, et al. : Anterior bone loss in cervical disc arthroplasty. Asian Spine J 13 : 13-21, 2019 https://doi.org/10.31616/asj.2018.0008
  12. Kim SH, Chung YS, Ropper AE, Min KH, Ahn TK, Won KS, et al. : Bone loss of the superior adjacent vertebral body immediately posterior to the anterior flange of Bryan cervical disc. Eur Spine J 24 : 2872-2879, 2015 https://doi.org/10.1007/s00586-015-3849-6
  13. Smith GW, Robinson RA : The treatment of certain cervical-spine disorders by anterior removal of the intervertebral disc and interbody fusion. J Bone Joint Surg Am 40-A : 607-624, 1958 https://doi.org/10.2106/00004623-195840030-00009
  14. Tumialan LM, Gluf WM : Progressive vertebral body osteolysis after cervical disc arthroplasty. Spine (Phila Pa 1976) 36 : E973-E978, 2011 https://doi.org/10.1097/BRS.0b013e3181fd863b
  15. Wenger M, Markwalder TM : Heterotopic ossification associated with myelopathy following cervical disc prosthesis implantation. J Clin Neurosci 26 : 154-156, 2016 https://doi.org/10.1016/j.jocn.2015.09.016