Document Detail


Complications with cervical arthroplasty.
MedLine Citation:
PMID:  16506475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Spinal arthroplasty is becoming more widely performed in the treatment of degenerative cervical disc disease. Although this new technology may offer benefits over arthrodesis, it also requires that the surgeon acquire new operative techniques, and new potential complications are introduced. To determine the incidence and distribution of perioperative complications, the authors analyzed their early data obtained in a series of patients treated with the Bryan Cervical Disc prosthesis. METHODS: The authors prospectively recorded operative data, complications, and clinical and radiographic outcome data in all patients treated with Bryan prosthesis-based arthroplasty at two tertiary care centers since 2001. Patients underwent standard anterior cervical discectomy followed by one- to three-level arthroplasty. Ninety-six discs were implanted in 74 patients. The perioperative complication rate was 6.2% per treated level. In one patient a retropharyngeal hematoma developed, requiring evacuation. Neurological worsening occurred in three patients. Intraoperative migration of the prosthesis was observed in one two-level case, whereas delayed migration occurred in one patient with postoperative segmental kyphosis. In another patient with severe postoperative segmental kyphosis, revision was required with a customized lordotic prosthesis. Heterotopic ossification and spontaneous fusion occurred in two cases; motion was preserved in the remaining 94 prostheses. Partial dislocation of the prosthesis in extension occurred in one patient with preoperative segmental hypermobility, the first reported failure of a Bryan prosthesis. Twenty-five percent of patients reported neck and shoulder pain during the late follow-up period. There was a trend toward increased kyphosis of the C2-7 curvature postoperatively. CONCLUSIONS: The Bryan prosthesis was effective in maintaining spinal motion. Major perioperative and device-related complications were infrequent.
Authors:
Gwynedd E Pickett; Lali H S Sekhon; William R Sears; Neil Duggal
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  4     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-03-01     Completed Date:  2006-03-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  98-105     Citation Subset:  IM    
Affiliation:
Division of Neurosurgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Arthroplasty, Replacement / adverse effects*,  methods
Cervical Vertebrae / pathology,  surgery
Diskectomy / adverse effects*,  methods
Female
Foreign-Body Migration
Humans
Incidence
Kyphosis / etiology
Male
Middle Aged
Neck Pain
Postoperative Complications* / epidemiology,  etiology
Prospective Studies
Prosthesis Failure
Radiculopathy / surgery
Range of Motion, Articular
Spinal Cord Diseases / surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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