Revision surgeries following artificial disc replacement of cervical spine
Objective: We investigated causes and results of revision surgeries after artificial disc replacement of cervical spine (C-ADR). Methods: Twenty-one patients (mean age: 52.8) who underwent revision surgery after C-ADR and who had a minimum 2-year of follow-up were included into this study. The mean...
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2016-12-01
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| Series: | Acta Orthopaedica et Traumatologica Turcica |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1017995X16302814 |
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| author | Jong-Beom Park Han Chang Jin S. Yeom Kyung-Soo Suk Dong-Ho Lee Jae Chul Lee |
| author_facet | Jong-Beom Park Han Chang Jin S. Yeom Kyung-Soo Suk Dong-Ho Lee Jae Chul Lee |
| author_sort | Jong-Beom Park |
| collection | DOAJ |
| description | Objective: We investigated causes and results of revision surgeries after artificial disc replacement of cervical spine (C-ADR). Methods: Twenty-one patients (mean age: 52.8) who underwent revision surgery after C-ADR and who had a minimum 2-year of follow-up were included into this study. The mean time between the primary and revision surgeries was 21 months. During their primary surgeries, 14 patients underwent single level C-ADR, 2 two-level C-ADR, and 5 two-level hybrid surgery for 16 radiculopathy, 3 myelopathy, and 2 adjacent segment diseases. Causes for revision surgeries were at least one of the followings: 17 poor patient selections, 7 insufficient decompressions, 7 malpositions, 6 subsidences, 3 osteolysis, and 1 postoperative infection. Results: Sixteen patients underwent anterior removal of C-ADR, one-level discectomy and fusion (N = 11), two-level discectomy (N = 3) or one-level corpectomy (N = 2) and fusion. Three patients of keel type C-ADR with heterotopic ossification underwent posterior laminoforaminotomy and fusion. Two patients underwent combined procedures due to infection or severe subsidence and osteolysis. At the 2-year follow-up, neck (7.3 vs 1.6) and arm (7.0 vs 1.3) visual analog scales and Neck Disability Index score (46.7 vs 16.32) were improved (all, p < 0.05). According to Odom's criteria, 86% of the patients were satisfied and 91% achieved solid fusion. No major complications developed except for transient dysphagia in 6 patients (29%). Conclusions: In this small case series, revision surgeries provided successful outcomes in failed C-ADR without major complications. Careful patient selection and meticulous surgical techniques are important to avoid disappointing clinical outcome or even failure of C-ADR. Level of evidence: Level IV, Therapeutic study. Keywords: Revision surgeries, Artificial disc replacement, Cervical spine |
| format | Article |
| id | doaj-art-e31268af2bfd471f80176288ce383f5e |
| institution | Kabale University |
| issn | 1017-995X |
| language | English |
| publishDate | 2016-12-01 |
| publisher | AVES |
| record_format | Article |
| series | Acta Orthopaedica et Traumatologica Turcica |
| spelling | doaj-art-e31268af2bfd471f80176288ce383f5e2025-08-20T03:39:28ZengAVESActa Orthopaedica et Traumatologica Turcica1017-995X2016-12-0150661061810.1016/j.aott.2016.04.004Revision surgeries following artificial disc replacement of cervical spineJong-Beom Park0Han Chang1Jin S. Yeom2Kyung-Soo Suk3Dong-Ho Lee4Jae Chul Lee5Department of Orthopedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea; Corresponding author.Department of Orthopedic Surgery, Busan Korea Hospital, Republic of KoreaDepartment of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Republic of KoreaDepartment of Orthopaedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Republic of KoreaDepartment of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Republic of KoreaDepartment of Orthopaedic Surgery, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Republic of KoreaObjective: We investigated causes and results of revision surgeries after artificial disc replacement of cervical spine (C-ADR). Methods: Twenty-one patients (mean age: 52.8) who underwent revision surgery after C-ADR and who had a minimum 2-year of follow-up were included into this study. The mean time between the primary and revision surgeries was 21 months. During their primary surgeries, 14 patients underwent single level C-ADR, 2 two-level C-ADR, and 5 two-level hybrid surgery for 16 radiculopathy, 3 myelopathy, and 2 adjacent segment diseases. Causes for revision surgeries were at least one of the followings: 17 poor patient selections, 7 insufficient decompressions, 7 malpositions, 6 subsidences, 3 osteolysis, and 1 postoperative infection. Results: Sixteen patients underwent anterior removal of C-ADR, one-level discectomy and fusion (N = 11), two-level discectomy (N = 3) or one-level corpectomy (N = 2) and fusion. Three patients of keel type C-ADR with heterotopic ossification underwent posterior laminoforaminotomy and fusion. Two patients underwent combined procedures due to infection or severe subsidence and osteolysis. At the 2-year follow-up, neck (7.3 vs 1.6) and arm (7.0 vs 1.3) visual analog scales and Neck Disability Index score (46.7 vs 16.32) were improved (all, p < 0.05). According to Odom's criteria, 86% of the patients were satisfied and 91% achieved solid fusion. No major complications developed except for transient dysphagia in 6 patients (29%). Conclusions: In this small case series, revision surgeries provided successful outcomes in failed C-ADR without major complications. Careful patient selection and meticulous surgical techniques are important to avoid disappointing clinical outcome or even failure of C-ADR. Level of evidence: Level IV, Therapeutic study. Keywords: Revision surgeries, Artificial disc replacement, Cervical spinehttp://www.sciencedirect.com/science/article/pii/S1017995X16302814 |
| spellingShingle | Jong-Beom Park Han Chang Jin S. Yeom Kyung-Soo Suk Dong-Ho Lee Jae Chul Lee Revision surgeries following artificial disc replacement of cervical spine Acta Orthopaedica et Traumatologica Turcica |
| title | Revision surgeries following artificial disc replacement of cervical spine |
| title_full | Revision surgeries following artificial disc replacement of cervical spine |
| title_fullStr | Revision surgeries following artificial disc replacement of cervical spine |
| title_full_unstemmed | Revision surgeries following artificial disc replacement of cervical spine |
| title_short | Revision surgeries following artificial disc replacement of cervical spine |
| title_sort | revision surgeries following artificial disc replacement of cervical spine |
| url | http://www.sciencedirect.com/science/article/pii/S1017995X16302814 |
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