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Surg Neurol Int. 2017 Jul 7;8:138. doi: 10.4103/sni.sni_386_15. eCollection 2017.

Cervical artificial disc extrusion after a paragliding accident.

Niu T1, Hoffman H1, Lu DC1,2,3,4.

Author information

1
Department of Neurosurgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
2
Department of Orthopedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
3
Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.
4
Brain Research Institute, University of California, Los Angeles, California, USA.

Abstract

BACKGROUND:

Cervical total disc replacement (TDR) is an established alternative to anterior cervical discectomy and fusion (ACDF) with excellent long-term outcomes and low failure rates. Cases of implant failure and migration are scarce and primarily limited to several years postoperatively. The authors report a case of anterior extrusion of a C4-C5 ProDisc-C (DePuy Synthes, West Chester, PA, USA) cervical artificial disc (CAD) 14 months after placement due to minor trauma.

CASE DESCRIPTION:

A 33-year-old female who had undergone C4-C5 CAD implantation presented with neck pain and spasm after experiencing a paragliding accident. A 4 mm anterior protrusion of the CAD was seen on x-ray. She underwent removal of the CAD followed by anterior fusion. Other cases of CAD extrusion in the literature are discussed and the device's durability and testing are considered.

CONCLUSION:

Overall, CAD extrusion is a rare event. This case is likely the result of insufficient osseous integration. Patients undergoing cervical TDR should avoid high-risk activities to prevent trauma that could compromise the disc's placement, and future design/research should focus on how to enhance osseous integration at the interface while minimizing excessive heterotopic ossification.

KEYWORDS:

Anterior cervical discectomy and fusion; cervical artificial disc; cervical spine trauma; osseous integration; total disc replacement

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