Brenke Christopher, Schmieder Kirsten, Barth Martin
Department of Neurosurgery, Knappschaftskrankenhaus Bochum, Ruhr-University of Bochum, In der Schornau 23-25, 44892, Bochum, Germany,
Eur Spine J. 2015 May;24 Suppl 4:S536-9. doi: 10.1007/s00586-014-3677-0. Epub 2014 Nov 18.
Cervical artificial discs (CADs) represent an established surgical option in selected patients with cervical spinal disc degeneration. Though CADs have been available for many years, there is a lack of information concerning long-term safety, durability and implant-related failure rates.
The authors describe the failure of a M6-C CAD (Spinal Kinetics, Sunnyvale, CA, USA).
Eight years after implantation of a CAD of the M6 type, a 39-year-old female presented with new clinical signs of cervical myelopathy. Radiologically, medullar compression due to posterior core herniation was the suspected cause. The damaged CAD was removed and the segment fused. During revision surgery, rupture of the posterior structures could be detected. Possible mechanisms leading to implant failure are discussed.
As there is no standard regarding clinical and radiological follow-up for patients with CADs, radiological long-term follow-up investigations seem to be justified for exclusion of implant failure.
颈椎人工椎间盘(CADs)是特定颈椎间盘退变患者既定的手术选择。尽管CADs已应用多年,但缺乏有关长期安全性、耐用性及植入物相关故障率的信息。
作者描述了一例M6-C CAD(美国加利福尼亚州森尼韦尔市Spinal Kinetics公司生产)的故障情况。
在植入M6型CAD八年后,一名39岁女性出现了新的脊髓型颈椎病临床症状。影像学检查怀疑是后芯疝导致脊髓受压。移除受损的CAD并进行节段融合。在翻修手术中,可检测到后部结构破裂。讨论了导致植入物故障的可能机制。
由于对于CADs患者的临床和影像学随访尚无标准,长期影像学随访检查对于排除植入物故障似乎是合理的。