Granulomatous Reaction on a Double-Level Cervical Total Disc Arthroplasty

Baltus, Cedric; Costa, Emmanuel; Vaz, G.; Raftopoulos, Christian

doi:10.1016/j.wneu.2018.11.070

Cited by 13 publications

(6 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Duration of implantation prior to reoperation ranged from 15-96 months. Radiographic analysis was performed at multiple time points, with progressive osteolysis observed in eight articles [26][27][28][29][30][31][32]. In twelve articles, the implants were removed.…”

Section: Reported Osteolysismentioning

confidence: 99%

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

et al. 2022

View full text Add to dashboard Cite

Background Periprosthetic bone loss is a common observation following arthroplasty. Recognizing and understanding the nature of bone loss is vital as it determines the subsequent performance of the device and the overall outcome. Despite its significance, the term “bone loss” is often misused to describe inflammatory osteolysis, a complication with vastly different clinical outcomes and treatment plans. Therefore, the goal of this review was to report major findings related to vertebral radiographic bone changes around cervical disc replacements, mitigate discrepancies in clinical reports by introducing uniform terminology to the field, and establish a precedence that can be used to identify the important nuances between these distinct complications. Methods A systematic review of the literature was conducted following PRISMA guidelines, using the keywords “cervical,” “disc replacement,” “osteolysis,” “bone loss,” “radiograph,” and “complications.” A total of 23 articles met the inclusion criteria with the majority being retrospective or case reports. Results Fourteen studies reported periprosthetic osteolysis in a total of 46 patients with onset ranging from 15–96 months after the index procedure. Reported causes included: metal hypersensitivity, infection, mechanical failure, and wear debris. Osteolysis was generally progressive and led to reoperation. Nine articles reported non-inflammatory bone loss in 527 patients (52.5%), typically within 3–6 months following implantation. The reported causes included: micromotion, stress shielding, and interrupted blood supply. With one exception, bone loss was reported to be non-progressive and had no effect on clinical outcome measures. Conclusions Non-progressive, early onset bone loss is a common finding after CDA and typically does not affect the reported short-term pain scores or lead to early revision. By contrast, osteolysis was less common, presenting more than a year post-operative and often accompanied by additional complications, leading to revision surgery. A greater understanding of the clinical significance is limited by the lack of long-term studies, inconsistent terminology, and infrequent use of histology and explant analyses. Uniform reporting and adoption of consistent terminology can mitigate some of these limitations. Executing these actionable items is critical to assess device performance and the risk of revision. Level of Evidence IV Diagnostic: individual cross-sectional studies with consistently applied reference standard and blinding.

show abstract

Section: Reported Osteolysismentioning

confidence: 99%

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

et al. 2022

View full text Add to dashboard Cite

show abstract

“…The same observations and comments can be done especially for the potential over solicitation of the implant in case of increased sagittal inclination of vertebral endplates and high rotational mobility. As at the lumbar level the weak point may be linked to the friction of the polyethylene fibers on the metal endplates with granulomatous reaction or the unexpected locking of the mobile nucleus[ 33 , 34 ].…”

Section: What Are the Challenges Facing The “Second-generation Tdr” Amentioning

confidence: 99%

Lumbar and cervical viscoelastic disc replacement: Concepts and current experience

Lazennec

2020

WJO

View full text Add to dashboard Cite

The ideal lumbar and cervical discs should provide six degrees of freedom and tri-planar (three-dimensional) motion. Although all artificial discs are intended to achieve the same goals, there is considerable heterogeneity in the design of lumbar and cervical implants. The “second generation total disc replacements” are non-articulating viscoelastic implants aiming at the reconstruction of physiologic levels of shock absorption and flexural stiffness. This review aims to give an overview of the available implants detailing the concepts and the functional results experimentally and clinically. These monobloc prostheses raise new challenges concerning the choice of materials for the constitution of the viscoelastic cushion, the connection between the components of the internal structure and the metal endplates and even the bone anchoring mode. New objectives concerning the quality of movement and mobility control must be defined.

show abstract

“…In three out of four cases, microbiology confirmed the presence of propionibacterium acnes, and histopathology revealed inflammatory changes as well as foreign body granuloma 5 . Case reports of mechanical implant failure and foreign body granulomas after M6-C disc replacement are few 20 , 21 , 22 .…”

Section: Discussionmentioning

confidence: 99%

“…Mikrobiologisch konnte bei 3 von 4 Fällen Propionibacterium acnes nachgewiesen werden, histopathologisch fanden sich neben einem Fremdkörpergranulom auch entzündliche Veränderungen 5 . Fallberichte zum mechanischen Implantatversagen und zu Fremdkörpergranulomen nach M6-C-Bandscheibenersatz finden sich in geringer Zahl 20 , 21 , 22 .…”

Section: Diskussionunclassified

A Rare Case of Wear Induced Complications after Cervical Disc Replacement

et al. 2021

View full text Add to dashboard Cite

Wear-induced complications after cervical disc replacement (CDR) are rare. A literature review on this topic found only a few case reports. We present a case of late complications after implantation of two cervical disc replacements, which resulted in infectious/abrasion-induced mixed-type inflammation with extensive osteolysis. The diagnostic workup, surgical therapy and outcome are presented and discussed with a review of the recent literature.

show abstract

Granulomatous Reaction on a Double-Level Cervical Total Disc Arthroplasty

Cited by 13 publications

References 12 publications

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

The lexicon for periprosthetic bone loss versus osteolysis after cervical disc arthroplasty: a systematic review

Lumbar and cervical viscoelastic disc replacement: Concepts and current experience

A Rare Case of Wear Induced Complications after Cervical Disc Replacement

Contact Info

Product

Resources

About