This article discusses a unique case of failure in a cervical disc replacement (CDR) procedure using the M6-C prosthesis. The patient, a 49-year-old female, experienced spinal cord injury as a result of a fractured arthroplasty that penetrated the spinal cord. Revision surgery was performed to remove the metal piece and repair the damage. The patient showed significant improvement after surgery. The authors highlight the importance of further discussions and counseling with patients regarding potential fatigue-related failures in CDR procedures. They also recommend establishing a patient registry to document adverse events. The keywords for this article include M6-C prosthesis, case report, cervical degenerative disc disease, and cervical disc arthroplasty
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spine clinic in UK
Published article
BACKGROUND: Cervical disc replacement (CDR) is an increasingly used alternative to fusion for symptomatic cervical disc disease. While more studies have suggested favorability of CDR over fusion procedures, limited data exist regarding implant fatigability. Here, the authors present a unique and previously unreported failure of the M6-C prosthesis causing spinal cord injury.
Cervical Disc Replacement Surgery Expert. Best Spinal Surgeon UK
Abstract Background: Cervical disc replacement (CDR) is an increasingly used alternative to fusion for symptomatic cervical disc disease. While more studies have suggested favorability of CDR over fusion procedures, limited data exist regarding implant fatigability. Here, the authors present a unique and previously unreported failure of the M6-C prosthesis causing spinal cord injury. Observations: A,
Abstract
Background: Cervical disc replacement (CDR) is an increasingly used alternative to fusion for symptomatic cervical disc disease. While more studies have suggested favorability of CDR over fusion procedures, limited data exist regarding implant fatigability. Here, the authors present a unique and previously unreported failure of the M6-C prosthesis causing spinal cord injury.
Observations: A 49-year-old female with history of cervical degenerative disease and prior C4-7 M6-C arthroplasty presented 9 years later after a minor fall from standing. She endorsed bilateral hand numbness ascending to forearms and shoulders, with dysesthesias and weakness. Imaging showed fractured arthroplasty penetrating the spinal cord. Revision surgery found a ruptured arthroplasty annulus with metal piece piercing the spinal cord. Partial C4 and C5 corpectomy was performed to remove the integrated fins of the arthroplasty and inspect the cord and dura. This was reconstructed with a corpectomy cage and plate. The patient made an excellent recovery, with improvement in her weakness and resolution of her sensory symptoms.
Lessons: Possibility of fatigue-related failures presenting years after implantation have only been infrequently reported but can be catastrophic for patients. The authors encourage further discussions in this area, increased counseling with patients, and recommend a patient registry to better document adverse events.
Keywords: M6-C prosthesis; case report; cervical degenerative disc disease; cervical disc arthroplasty.
The London Spine Unit : best recognised spine clinic in UK
Read the original publication:
Catastrophic delayed cervical arthroplasty failure: illustrative case
