Advertisement

Surgical Technique, Subaxial Spine: Cervical Disc Replacement Revision Surgery

  • Justin A. Iorio
  • Stelios Koutsoumbelis
  • Han Jo Kim
  • Todd J. Albert
Chapter

Abstract

Cervical disc replacement (CDR) has a high success rate. However, failure may occur due to persistent radiculopathy or myelopathy, malposition, heterotopic ossification, infection, subsidence, bearing wear, sizing error, and vertebral body fracture. Preoperative planning prior to revision surgery requires a complete history and physical, operative note from the index surgery, identification of implant information, imaging (radiographs, CT, and/or MRI), and determination of the etiology of CDR failure. Explanting the device and performing a fusion with a cage or graft may be performed for one-level revision. Corpectomy and fusion should be considered for two or greater levels of CDR revision because it reduces the number of graft-bone interfaces that require fusion, provides a large amount of autograft, affords stability, and removes the fibrinous on growth that occurs under the baseplates from the original surgery. Revision is associated with a greater complication rate than primary CDR, and consideration must be given to mitigating factors that predispose to adverse events.

Supplementary material

370679_1_En_53_MOESM1_ESM.pptx (68.9 mb)
Data 53.1 iorio.ppt (PPTX 70569 kb)
Video 53.1

VIDEO_justiniorio (MP4 64237 kb)

Bibliography

  1. 1.
    Nandyala SV, Marquez-Lara A, Fineberg SJ, et al. Comparison of revision surgeries for one- and two-level cervical TDR and ACDF from 2002 to 2011. Spine J. 2014;14(12):2841–6.CrossRefGoogle Scholar
  2. 2.
    Rihn JA, Radcliff K, Hipp J, et al. Radiographic variables that may predict clinical outcomes in cervical disk replacement surgery. J Spinal Disord Tech. 2015;28(3):106–13.CrossRefGoogle Scholar
  3. 3.
    Nunley PD, Jawahar A, Kerr EU, et al. Factors affecting the incidence of symptomatic adjacent-level disease in cervical spine after total disc arthroplasty. Spine (Phila PA 1976). 2012;37(6):445–51.CrossRefGoogle Scholar
  4. 4.
    Hacker FM, Babcock RM, Hacker RJ. Very late complications of cervical arthroplasty: results of 2 controlled randomized prospective studies from a single investigator site. Spine (Phila PA 1976). 2013;38(26):2223–6.CrossRefGoogle Scholar
  5. 5.
    Skovrlj B, Lee DH, Caridi JM, et al. Reoperations following cervical disc replacement. Asian Spine J. 2015;9(3):471–82.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Justin A. Iorio
    • 1
  • Stelios Koutsoumbelis
    • 2
  • Han Jo Kim
    • 3
  • Todd J. Albert
    • 4
  1. 1.Syracuse Orthopedic SpecialistsSyracuseUSA
  2. 2.The Central Orthopedic GroupPlainviewUSA
  3. 3.Spine and Scoliosis CenterSchön Clinics VogtareuthVogtareuthGermany
  4. 4.Hospital for Special SurgeryNew YorkUSA

Personalised recommendations