Metallosis after traumatic loosening of Bryan cervical disc arthroplasty: a case report and literature review

Yang, Cheng-Kuang; Tang, Chien-Lun; Tzeng, Chung‐Yuh; Tsou, Hsi‐Kai

doi:10.1007/s00586-017-5397-8

Cited by 12 publications

(13 citation statements)

References 14 publications

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“…Compared with anterior cervical discectomy and fusion (ACDF), many studies have shown it offers equivalent clinical outcomes while reducing secondary procedures and total cost [1−5]. Meanwhile, with more widespread use, some complications, including metallosis [6], heterotopic ossification [7], hypermobility, and subsidence, have been reported [8−10].…”

Section: Introductionmentioning

confidence: 99%

Anterior bone loss after cervical Bryan disc arthroplasty: insight into the biomechanics following total disc replacement

Chen

Tzeng

et al. 2020

The Spine Journal

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BACKGROUND CONTEXT: Cervical disc arthroplasty (CDA) is an innovative procedure launched in the early 2000s. Compared with anterior cervical discectomy and fusion, many studies show that CDA offers equivalent clinical outcomes while reducing secondary procedures and total cost. PURPOSE: We sought to determine the incidence of anterior bone loss after CDA and the related biomechanical effects. STUDY DESIGN/ SETTING: Retrospective chart review. PATIENT SAMPLE: Patients who underwent CDA with one level Bryan Disc (Medtronic Sofa-morDanek, Memphis, TN, USA) at one institution. OUTCOME MEASURES: Radiological measurements, including the extent of anterior bone loss, global alignment angle, shell angle, lordotic angle, mean degree of angle of the endplate with the horizontal line, global range of motion (ROM) and ROM of the index level were recorded. The grading of anterior bone loss of the index level was defined as Grade 0, no remodeling; Grade 1, spur disappearance or mild change in body contour; Grade 2, obvious bone regression with Bryan Disc exposure.

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Section: Introductionmentioning

confidence: 99%

Anterior bone loss after cervical Bryan disc arthroplasty: insight into the biomechanics following total disc replacement

Chen

Tzeng

et al. 2020

The Spine Journal

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“… [1] , [2] , [3] , [4] , [5] The literature on trauma after both ACDF and CDA is sparse and primarily limited to case reports ( Table 1 ). [6] , [7] , [8] , [9] , [10] , [11] , [12] , [15] , [16] , [17] , [18] Furthermore, our patient sustained a high-speed traumatic axial (C2) fracture 1.5 years after an CDA resulting in an intact ACD implant; an incidence that has not been described in any case-report to our knowledge. Our discussion will provide a review of current literature describing complications due to trauma after CDA and ACDF, a biomechanical discussion of forces required to illicit device migration and Hangman's fracture, and a hypothesis to guide further research.…”

Section: Discussionmentioning

confidence: 67%

“… [1] , [2] , [3] Few studies have demonstrated risks associated with high-energy trauma after CDA ( Table 1 ), and to our knowledge, this is the only study describing a grossly intact artificial cervical disk (ACD) without extrusion after high-energy trauma. [6] , [7] , [8] , [9] , [10] , [11] , [12] While the risk of ACD implant translation remains, this case-report and literature review investigate the question of whether CDA or anterior discectomy and fusion (ACDF) may be the preferred approach for younger patients at higher risk for trauma.…”

Section: Purposementioning

confidence: 99%

“…C6/C7 Fall 4 months Posterior dislocation and cervical fracture Removal, no further data Yang, C. C., et al. [12] 1 CDA/C6-C7 Bryan Disc© [4] Hyperflexion-extension whiplash injury from MVA 8 years Metallosis and anterior migration of the superior disk aspect Removal and fusion with resolution of symptoms Watkins, R. G. t., et al. [15] 3 ACDF/C3-C4, C4-C5, C4-C5 Titanium-coated PEEK (polyetheretherketone) graft filled with iliac crest autograft and plate Anterior extension from return to sports 1.7-8 years Adjacent disk disease ACDF of adjacent disk Maroon, J. C., et al.…”

Section: Purposementioning

confidence: 99%

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Traumatic hangman's fracture after cervical disk arthroplasty with device in-tact: A case report and literature review

Fuller

Geiger

Gomez

et al. 2020

North American Spine Society Journal (NASSJ)

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Cervical disk arthroplasty anterior cervical discectomy and fusion trauma artificial disk extrusion Prodisc-C a b s t r a c t Background Context: Cervical disk arthroplasty (CDA) has been demonstrated to be a safe and effective method to treat myelopathy with the added benefit of preserving neck mobility compared to anterior cervical discectomy and fusion (ACDF). Few studies describe complications of trauma after CDA, and to our knowledge this is the only study describing a grossly intact artificial cervical disk (ACD) without extrusion after high energy trauma. Based on our case and a review of literature, we hypothesize that, given adequate osseous integration (OI), CDA may be a safe intervention despite their risk for higher energy trauma.Purpose: To present a rare case of high-energy trauma after CDA resulting in a Hangman's fracture and grossly in-tact ACD and to engage a biomechanical discussion of trauma after CDA and ACDF utilizing a literature review.Study Design/Setting: Case-report with literature review and discussion Patient Sample: Electronic medical record data Outcome Measures: Computed Tomography, Magnetic Resonance Imaging, and X-Ray physiologic measures Methods: We report the case of a 44-year-old woman who received a C5-C6 level CDA with a (Synthes Prodisc-C©, Synthes Spine Company, L.P., West Chester, PA) and was subsequently involved in a high-speed motorcycle accident one-and-a-half years later resulting in a Hangman's fracture.

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“…Metallosis, a similar condition in which periprosthetic metal particle deposition results in osteolysis, was also described in the setting of a metal-on-metal artificial disk. 92 These potential long-term complications of artificial disk replacements are likely rare, but their prevalence is yet to be determined.…”

Section: Hardware Failurementioning

confidence: 99%

Update on Imaging of Spinal Fixation Hardware

Winegar

Kay

Chadaz

et al. 2019

Semin Musculoskelet Radiol

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This article discusses instrumented spinal surgeries, the radiologic assessment of spinal fixation hardware, and the potential complications of spinal hardware. Radiography is the standard for the postoperative assessment of spinal hardware. Computed tomography and magnetic resonance imaging play a valuable role in the detection of hardware and postsurgical-related complications such as infection, pseudarthrosis, and malpositioned instrumentation. Familiarity with the normal imaging appearance of implanted spinal hardware along with the expected progression of normal postoperative osseous arthrodesis enables recognition of potential complications and helps facilitate appropriate clinical management.

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Metallosis after traumatic loosening of Bryan cervical disc arthroplasty: a case report and literature review

Cited by 12 publications

References 14 publications

Anterior bone loss after cervical Bryan disc arthroplasty: insight into the biomechanics following total disc replacement

Anterior bone loss after cervical Bryan disc arthroplasty: insight into the biomechanics following total disc replacement

Traumatic hangman's fracture after cervical disk arthroplasty with device in-tact: A case report and literature review

Update on Imaging of Spinal Fixation Hardware

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