An anterior dislocation after Mobi-C cervical disc arthroplasty

Abstract

The objective is to report a case of an early dislocation of Mobi-C prosthesis used for the replacement of C4–C5 disc. A 57-year-old man who was operated 17 years before for C6–C7 fusion complained of cervicalgia associated with bilateral but predominantly right-sided brachialgia. Magnetic resonance imaging demonstrated central and foraminal stenosis in the C5–C6 segment and soft medial disc herniation in the C4–C5 segment. The patient was indicated for the placement of a cervical disc prosthesis C4–C5 and a C5–C6 arthrodesis. After 1 month of clinical improvement, the patient saw his pain reappearing as well as the presence of dysphagia not objectified before. The patient did not describe a traumatic context. The radiographic assessment showed an anterior dislocation of the prosthesis. The patient was reoperated, the prosthesis was removed, and cervical arthrodesis with iliac graft was performed. Although rare, this complication must be well known by surgeons performing cervical arthroplasty.

Incidence and Risk Factor of Implant Dislocation After Cervical Disk Arthroplasty: A Retrospective Cohort Analysis of 756 Patients

“…to aid in fixation. 20,[28][29][30] It seems that the stability of implants is not only related to the anchoring of the implant, so we performed a logistic regression analysis with a larger population and discovered that preoperative kyphosis is significantly associated with postoperative implant dislocation. It is worth mentioning that patients with kyphosis are not good candidates for CDA.…”

“…The timing of implant dislocation has been inconsistent, according to previous reports. 4,[20][21][22][23][24][25][26][27][28][29][30] Moreover, reports have warned that implant dislocation could occur beyond 3 to 6 months postoperatively. 27 However, we found that most migrations can be seen on plain radiographs at the early postoperative visit, which is about 0.9 to 1.4 months postoperatively.…”

“…[21][22][23][24][25][26][27] Moreover, they were all aimed at the Bryan Cervical Disc (Medtronic Sofamor Danek), which is a nonconstrained design and is no longer the mainstream for CDA now. Other case reports directed at the semiconstrained designs are sporadic, 20,[28][29][30] so it is quite difficult to estimate the incidence of implant dislocation. Furthermore, the associated risk factor remains unknown.…”

Past, Present, and Future of Cervical Disc Arthroplasty

“…CDA decreases the risks of certain potential adverse events of ACDF, such as pseudarthrosis 16 . However, as with all surgical procedures, they also have their own unique set of adverse events due to their motion preservation mechanics, including heterotopic ossification, osteolysis, and dislocation 17–20 …”

“…16 However, as with all surgical procedures, they also have their own unique set of adverse events due to their motion preservation mechanics, including heterotopic ossification, osteolysis, and dislocation. [17][18][19][20]…”