Cavanaugh David A, Nunley Pierce D, Kerr Eubulus J, Werner David J, Jawahar Ajay
Spine Institute of Louisiana, 1500 Line Avenue, Shreveport, LA 71101, USA.
Spine (Phila Pa 1976). 2009 Apr 1;34(7):E262-5. doi: 10.1097/BRS.0b013e318195dd60.
Anecdotal case report.
To report a very interesting and perplexing complication of cervical total disc arthroplasty that has not been previously reported in literature.
Although there has been increasing interest in the field of artificial disc replacement to treat cervical degenerative disc disease, not much has been mentioned in the literature about the potential complications of the disc itself. We encountered a delayed complication in 1 patient that has not been reported in the literature.
Thirty-nine-year-old white woman received total disc arthroplasty for herniated intervertebral disc at C5-C6 level uneventfully. She had recurrence of symptoms 9 months after the procedure and failed to respond to conservative measurements. Imaging revealed soft tissue mass posterior to the implanted disc encroaching the spinal cord.
Surgical explantation and exploration of the disc space revealed thick layer of abnormal hyaline cartilaginous tissue with chronic inflammatory debris. The patient had complete resolution of symptoms after the revision surgery.
Although there is increased enthusiasm about motion preservation technology and disc replacement surgery for intervertebral disc herniation, unexpected complications like the present case need to be shared within the scientific community to better understand the risks associated with these new and promising devices.
病例报告。
报告一种颈椎全椎间盘置换术的非常有趣且令人困惑的并发症，此前文献中尚未有报道。
尽管人工椎间盘置换治疗颈椎退行性椎间盘疾病领域的关注度不断提高，但文献中关于椎间盘本身潜在并发症的提及并不多。我们遇到了1例文献中未报道的延迟性并发症。
一名39岁的白人女性接受了C5 - C6节段椎间盘突出症的全椎间盘置换术，手术过程顺利。术后9个月症状复发，保守治疗无效。影像学检查显示植入椎间盘后方有软组织肿块压迫脊髓。
对椎间盘间隙进行手术切除和探查发现有一层厚厚的异常透明软骨组织，伴有慢性炎性碎屑。翻修手术后患者症状完全缓解。
尽管对于保留运动技术和椎间盘置换手术治疗椎间盘突出症的热情日益高涨，但像本病例这样的意外并发症需要在科学界分享，以便更好地了解这些新的有前景的器械相关风险。
