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...

Full description

Saved in:
Bibliographic Details
Main Authors: Jong-Beom Park, Han Chang, Jin S. Yeom, Kyung-Soo Suk, Dong-Ho Lee, Jae Chul Lee
Format: Article
Language:English
Published: AVES 2016-12-01
Series:Acta Orthopaedica et Traumatologica Turcica
Online Access:http://www.sciencedirect.com/science/article/pii/S1017995X16302814
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849395935680921600
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
work_keys_str_mv AT jongbeompark revisionsurgeriesfollowingartificialdiscreplacementofcervicalspine
AT hanchang revisionsurgeriesfollowingartificialdiscreplacementofcervicalspine
AT jinsyeom revisionsurgeriesfollowingartificialdiscreplacementofcervicalspine
AT kyungsoosuk revisionsurgeriesfollowingartificialdiscreplacementofcervicalspine
AT dongholee revisionsurgeriesfollowingartificialdiscreplacementofcervicalspine
AT jaechullee revisionsurgeriesfollowingartificialdiscreplacementofcervicalspine