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Periprosthetic Osteolysis in Cervical Total Disc Arthroplasty: A Single Institutional Experience
Journal article   Open access   Peer reviewed

Periprosthetic Osteolysis in Cervical Total Disc Arthroplasty: A Single Institutional Experience

Julius O Ebinu, Dinesh Ramanathan, Steven M Kurtz, Shokry Lawandy and Kee D Kim
Neurosurgery Open, v 2(2)
2021
DOI: https://doi.org/10.1093/neuopn/okab013
url
https://doi.org/10.1093/neuopn/okab013View
Published, Version of Record (VoR)CC BY-NC V4.0,  Open

Abstract

Cervical spondylosis Periprosthetic osteolysis Spine Cervical disc arthroplasty Degenerative disc disease
ABSTRACT BACKGROUND Cervical disc arthroplasty (CDA) affords an excellent alternative to cervical fusion for the treatment of symptomatic patients with degenerative disc disease. As more surgeons perform CDAs, an understanding of the complications associated with this technique is crucial. Periprosthetic osteolysis (PO) is a rare potential complication associated with CDA. OBJECTIVE To highlight potential complications associated with CDA. METHODS A retrospective chart review of patients who underwent CDA at our institution was performed. Patient outcomes and relevant clinical and radiographical data were analyzed in addition to associated complications. Explanted devices were subjected to macroscopic and microscopic analyses. RESULTS A total of 88 patients were included: 68 patients underwent 1-level CDA and 20 patients had 2-level CDA. Implants used in this series included Mobi-C (Zimmer Biomet), Prestige LP (Medtronic), Secure C (Globus), Advent (Orthofix), and ProDisc C (DePuy). One patient demonstrated symptoms of myeloradiculopathy that correlated with radiographical periprosthetic osteolysis and required surgical intervention in the form of disc explantation, corpectomy, and cervical instrumented fusion. Device retrieval analysis demonstrated evidence of elevated oxidation levels and increased wear in the presence of high concentrations of metal ions and debris in the surrounding tissue. The tissue did not exhibit any immune response, infection, or acute inflammation. CONCLUSION PO is a potential complication of CDA that occurs irrespective of the type of implant used. We describe its occurrence and management and highlight the importance of being aware of this understated phenomenon.

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