Joaquim Andrei Fernandes, Lee Nathan J, Riew K Daniel
Department of Neurosurgery, University of Campinas (UNICAMP), Campinas, SP, Brazil.
Department of Orthopaedics, Columbia University Medical Center, The Och Spine Hospital at New York-Presbyterian, New York, NY, USA.
Neurospine. 2021 Mar;18(1):34-44. doi: 10.14245/ns.2040454.227. Epub 2021 Mar 31.
To perform a systematic literature review on revision surgeries at the index level after cervical disc arthroplasty (CDA) failure.
A systematic literature review was performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Prospective studies on patients who required a secondary surgery after CDA failure were included for analysis. The minimum follow-up for these studies was 5 years.
Out of 864 studies in the original search group, a total of 20 studies were included. From a total of 4,087 patients, 161 patients required a reoperation at the index level. A total of 170 surgeries were performed, as some patients required multiple surgeries. The most common secondary procedures were anterior cervical discectomy and fusion (ACDF) (68%, N = 61) and posterior cervical fusion (15.5%, N = 14), followed by other reoperation (13.3%, N = 12). The associated outcomes for those who required a revision surgery were rarely mentioned in the included literature.
The long-term revision rate at the index level of failed CDA surgery was 3.9%, with a minimum 5-year follow-up. ACDF was the most commonly performed procedure to salvage a failed CDA. Some patients who required a new surgery after CDA failure may require a more extensive salvage procedure and even subsequent surgeries.
对颈椎间盘置换术（CDA）失败后在初次手术节段进行翻修手术进行系统的文献综述。
根据PRISMA（系统评价和Meta分析的首选报告项目）指南进行系统的文献综述。纳入对CDA失败后需要二次手术的患者的前瞻性研究进行分析。这些研究的最短随访时间为5年。
在最初检索组的864项研究中，共纳入20项研究。在总共4087例患者中，161例患者需要在初次手术节段再次手术。共进行了170次手术，因为一些患者需要多次手术。最常见的二次手术是颈椎前路椎间盘切除融合术（ACDF）（68%，N = 61）和颈椎后路融合术（15.5%，N = 14），其次是其他再次手术（13.3%，N = 12）。纳入文献中很少提及需要翻修手术患者的相关结局。
CDA手术失败后在初次手术节段的长期翻修率为3.9%，最短随访5年。ACDF是挽救失败的CDA最常用的手术方法。一些CDA失败后需要再次手术的患者可能需要更广泛的挽救手术甚至后续手术。
