This article discusses a rare complication known as posterior intraprosthetic dislocation that can occur following cervical disc arthroplasty, a treatment for cervical disc herniation. The case study focuses on a 40-year-old man who experienced this complication nine months after undergoing the procedure. Imaging confirmed the dislocation, and emergency surgery was performed to replace the prosthesis with an anterior cervical discectomy and fusion (ACDF) and anterior plate. The patient had no neurological deficits and had a successful recovery. The article highlights the importance of spine surgeons being aware of this potential complication
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : most specialised treatment facility on Harley Street UK
Published article
BACKGROUND: Cervical disc herniation is a common condition usually treated with anterior cervical discectomy and fusion (ACDF) or, more recently, with cervical disc arthroplasty (CDA). Both treatments offer similar clinical results. However, CDA has been found to offer fewer medium- to long-term complications as well as potential reduction of long-term adjacent disc degeneration.
Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Background: Cervical disc herniation is a common condition usually treated with anterior cervical discectomy and fusion (ACDF) or, more recently, with cervical disc arthroplasty (CDA). Both treatments offer similar clinical results. However, CDA has been found to offer fewer medium- to long-term complications as well as potential reduction of long-term adjacent disc degeneration. Observations:,
Abstract
Background: Cervical disc herniation is a common condition usually treated with anterior cervical discectomy and fusion (ACDF) or, more recently, with cervical disc arthroplasty (CDA). Both treatments offer similar clinical results. However, CDA has been found to offer fewer medium- to long-term complications as well as potential reduction of long-term adjacent disc degeneration.
Observations: A 40-year-old man was treated with cervical discectomy and arthroplasty due to a C6-C7 disc herniation with left C7 radiculopathy. After the treatment, his postoperative follow-up appointments were uneventful for 9 months. However, after 9 months, he reported cervical pain and a right C7 radiculopathy after neck extension. Imaging confirmed a posterior intraprosthetic dislocation, the first case reported to date. The patient was received emergency surgery under neuromonitoring, and the prosthesis was replaced by an ACDF and anterior plate. The insert presented a rupture of the anterior horn. The patient presented no preoperative or postoperative neurological deficit, and his follow-up review revealed no issues.
Lessons: Posterior intraprosthetic dislocation is an extremely rare complication. It may occur with Mobi-C cervical arthroplasty in the case of rupture and oxidation of the polyethylene insert. Spine surgeons should be aware of this potential major complication.
Keywords: ACDF = anterior cervical discectomy and fusion; CDA = cervical disc arthroplasty; MRI = magnetic resonance imaging; Mobi-C; NRS = numerical rating scale; cervical arthroplasty; intraprosthetic dislocation; spinal cord compression.
The London Spine Unit : most specialised treatment facility on Harley Street UK
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Posterior intraprosthetic dislocation of cervical arthroplasty: illustrative case
