TY - JOUR
T1 - Short-term and Long-term Complications of Cervical Disc Arthroplasty
AU - Nguyen, Austin Q.
AU - Credille, Kevin
AU - Saifi, Comron
N1 - Funding Information:
C.S.: was supported by Alphatec—Shareholder and Medtronic—consulting.
Publisher Copyright:
© 2023 Lippincott Williams and Wilkins. All rights reserved.
PY - 2023/11/1
Y1 - 2023/11/1
N2 - Study Design: A narrative review. Objective: This review discusses the short and long-term complications associated with cervical disc arthroplasty (CDA). Summary of Background Data: CDA is a safe and effective motion-sparing alternative to fusion for the treatment of cervical disc pathology in patients with cervical radiculopathy or myelopathy. Although CDA offers advantages over fusion within a narrower set of indications, it introduces new technical challenges and potential complications. Methods: A systematic search of several large databases, including Cochrane Central, PubMed, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry, was conducted from January 2005 to August 2023 to identify published studies and clinical trials evaluating cervical disc replacement complications and outcomes. Results: Short-term complications are primarily related to surgical approach and include dysphagia reported as high as 70%, laryngeal nerve injury 0%-1.25%, Horner syndrome 0.06%, hematoma 0.01%, gross device extrusion 0.3%, whereas long-term complications include adjacent segment disease reported at 3.8%, osteolysis 44%-64%, heterotopic ossification 7.3%-69.2%, implant failure 3.3%-3.7%, and implant wear, which varies depending on design. Conclusions: Approaches for mitigating complications broadly include meticulous dissection, intraoperative techniques, and diligent postoperative follow-up. This review emphasizes the need for a comprehensive understanding and management of complications to enhance the safety, reproducibility, and success of CDA. As CDA continues to evolve, there remains a critical need for ongoing research to delve deeper into evaluating risk for complications and long-term patient outcomes.
AB - Study Design: A narrative review. Objective: This review discusses the short and long-term complications associated with cervical disc arthroplasty (CDA). Summary of Background Data: CDA is a safe and effective motion-sparing alternative to fusion for the treatment of cervical disc pathology in patients with cervical radiculopathy or myelopathy. Although CDA offers advantages over fusion within a narrower set of indications, it introduces new technical challenges and potential complications. Methods: A systematic search of several large databases, including Cochrane Central, PubMed, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry, was conducted from January 2005 to August 2023 to identify published studies and clinical trials evaluating cervical disc replacement complications and outcomes. Results: Short-term complications are primarily related to surgical approach and include dysphagia reported as high as 70%, laryngeal nerve injury 0%-1.25%, Horner syndrome 0.06%, hematoma 0.01%, gross device extrusion 0.3%, whereas long-term complications include adjacent segment disease reported at 3.8%, osteolysis 44%-64%, heterotopic ossification 7.3%-69.2%, implant failure 3.3%-3.7%, and implant wear, which varies depending on design. Conclusions: Approaches for mitigating complications broadly include meticulous dissection, intraoperative techniques, and diligent postoperative follow-up. This review emphasizes the need for a comprehensive understanding and management of complications to enhance the safety, reproducibility, and success of CDA. As CDA continues to evolve, there remains a critical need for ongoing research to delve deeper into evaluating risk for complications and long-term patient outcomes.
KW - arthroplasty
KW - cervical disc replacement
KW - complications
KW - Diskectomy/methods
KW - Intervertebral Disc Degeneration/surgery
KW - Reproducibility of Results
KW - Humans
KW - Cervical Vertebrae/surgery
KW - Treatment Outcome
KW - Arthroplasty/adverse effects
KW - Spinal Fusion/methods
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U2 - 10.1097/BSD.0000000000001541
DO - 10.1097/BSD.0000000000001541
M3 - Review article
C2 - 37752635
AN - SCOPUS:85176496084
SN - 2380-0186
VL - 36
SP - 404
EP - 410
JO - Clinical Spine Surgery
JF - Clinical Spine Surgery
IS - 9
ER -