Lee Chong-Suh, Chung Sung-Soo, Park Jae-Chul, Shin Seong-Kee, Park Yong-Serk, Kang Kyung-Chung
Department of Orthopaedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Asian Spine J. 2011 Jun;5(2):125-9. doi: 10.4184/asj.2011.5.2.125. Epub 2011 May 2.
This is a case report of a 38-year-old man with severe radiating pain on upper extremity after cervical total disc replacement (TDR). We faced an unusual complication that has not been reported yet. He underwent cervical TDR for left central disc protrusion on C5-6. After the surgery, preoperative symptom disappeared. However, at postoperative 1 year, he complained severe right-sided radiating pain that had a sudden onset. On postoperative X-ray, a metal fragment which seemed like a broken drill bit was shown within the spinal canal. To remove that, right-sided anterior microforaminotomy on C5-6 was performed and the metal fragment was removed successfully. After that, anterior fusion was done because the motion of the artificial disc was minimal and the removed structure seemed to attenuate stability during cervical motion. The operation resulted in prompt symptomatic relief. During cervical TDR, particular attention should be paid to the procedures that require using drill-bits.
这是一例38岁男性在颈椎全椎间盘置换术（TDR）后出现上肢严重放射痛的病例报告。我们遇到了一种尚未见报道的罕见并发症。他因C5-6节段左侧中央型椎间盘突出接受了颈椎TDR手术。术后，术前症状消失。然而，术后1年，他突然出现严重的右侧放射痛。术后X线检查显示椎管内有一个看似断裂钻头的金属碎片。为取出该碎片，对C5-6节段进行了右侧前路显微椎间孔切开术，并成功取出了金属碎片。此后，由于人工椎间盘活动度极小，且取出的结构似乎在颈椎活动时削弱了稳定性，遂进行了前路融合术。手术使症状迅速缓解。在颈椎TDR手术过程中，应特别注意使用钻头的操作步骤。
