Harati Ali, Oni Paul, Oles Lucas, Reuter Thomas, Hamdan Mohammad
Klinik für Neurochirurgie, Klinikum Dortmund GmbH, Dortmund, Germany.
Department of Neurosurgery, Mediapark Klinik, Cologne, NRW, Germany.
J Neurol Surg A Cent Eur Neurosurg. 2020 Mar;81(2):188-192. doi: 10.1055/s-0039-1698435. Epub 2020 Jan 21.
Cervical arthroplasty is an accepted and widely performed surgical intervention with usually favorable outcomes. We report a rare case of a 37-year-old woman who presented with vertebral body osteolysis, 6 years after two-level cervical arthroplasty (C5-C6 and C6-C7). The patient showed no initial complications, but at year 6 she presented with neck and radicular arm pain. Diagnostic imaging revealed osteolysis of the vertebral body C6. The patient subsequently underwent removal of the two prostheses and C6 corpectomy, followed by bridging C5 to C7 and anterior fixation. During surgery, the mantle of the prostheses appeared broken, with the core expulsed anteriorly and embedded in granulomatous scar tissue. Pathologic evaluation of the samples showed partially proliferating fibroblasts, giant cell reaction, and textile particles. Postoperatively, clinical symptoms resolved with no residual deficits. Additional research should be performed to assess the long-term complications of this procedure that should be included in the patient informed consent materials.
颈椎置换术是一种被广泛接受且实施广泛的外科手术干预，通常预后良好。我们报告了一例罕见病例，一名37岁女性在接受两节段颈椎置换术（C5-C6和C6-C7）6年后出现椎体骨质溶解。患者最初未出现并发症，但在第6年时出现颈部和神经根性手臂疼痛。诊断性影像学检查显示C6椎体骨质溶解。患者随后接受了两枚假体取出及C6椎体次全切除，接着进行了C5至C7的桥接和前路固定。手术过程中，假体的外壳出现破裂，核心向前排出并嵌入肉芽肿性瘢痕组织中。样本的病理评估显示有成纤维细胞部分增生、巨细胞反应和纺织颗粒。术后，临床症状得到缓解，无残留神经功能缺损。应开展更多研究以评估该手术的长期并发症，并将其纳入患者知情同意书中。
