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M6-C 型假体在混合构建中的失败:两例报告

M6-C prosthesis failure in hybrid construction : a double case report.

出版信息

Acta Orthop Belg. 2020 Dec;86(4):724-728.

Abstract

Cervical disc arthroplasty (CDA) is a well known treatment for single level cervical disc degeneration. In multi level disc degeneration anterior cervical disc fusion (ACDF) is often combined with a CDA. In this hybrid construction, motion is preserved at the level of the CDA. This will give less stiffness in the neck and decreases stress at the adjacent level. However, there is a lack of literature about the long term efficacy, safety and complication rate of CDA in hybrid constructions. In this article we present two cases of spontaneous destruction of a M6-C prosthesis in a hybrid construction 5 years after surgery. One reason seems to be the polymer sheath who is used in the M6 prosthesis. Degradation of this sheath causes foreign body reactions with osteolysis in the vertebral bodies. However, the increased mechanical loading at the adjacent levels on the CDA due to the fused vertebrae could also be one of the reasons.

摘要

颈椎间盘置换术 (CDA) 是治疗单节段颈椎间盘退变的一种常用方法。在多节段椎间盘退变中,常将前路颈椎间盘融合术 (ACDF) 与 CDA 联合应用。在这种混合结构中,CDA 节段保留了运动功能。这将使颈部的僵硬程度降低,并减少相邻节段的压力。然而,关于混合结构中 CDA 的长期疗效、安全性和并发症发生率的文献还很缺乏。在本文中,我们报告了两例混合结构中 M6-C 假体在手术后 5 年自发破坏的病例。一个原因似乎是 M6 假体中使用的聚合物护套。该护套的降解导致了异物反应,椎体出现了骨溶解。然而,由于融合的椎骨,CDA 相邻节段的机械负荷增加也可能是原因之一。

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