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Revision surgeries following artificial disc replacement of cervical spine

Authors
 Jong-Beom Park  ;  Han Chang  ;  Jin S. Yeom  ;  Kyung-Soo Suk  ;  Dong-Ho Lee  ;  Jae Chul Lee 
Citation
 Journal of Korean Society on Water Environment (한국물환경학회지), Vol.50(6) : 610-618, 2016 
Journal Title
 Journal of Korean Society on Water Environment  (한국물환경학회지) 
ISSN
 1738-2947 
Issue Date
2016
Abstract
OBJECTIVE: We investigated causes and results of revision surgeries after artificial disc replacement of cervical spine (C-ADR). METHODS: Twenty-one patients (mean age: 52.8) who underwent revision surgery after C-ADR and who had a minimum 2-year of follow-up were included into this study. The mean time between the primary and revision surgeries was 21 months. During their primary surgeries, 14 patients underwent single level C-ADR, 2 two-level C-ADR, and 5 two-level hybrid surgery for 16 radiculopathy, 3 myelopathy, and 2 adjacent segment diseases. Causes for revision surgeries were at least one of the followings: 17 poor patient selections, 7 insufficient decompressions, 7 malpositions, 6 subsidences, 3 osteolysis, and 1 postoperative infection. RESULTS: Sixteen patients underwent anterior removal of C-ADR, one-level discectomy and fusion (N = 11), two-level discectomy (N = 3) or one-level corpectomy (N = 2) and fusion. Three patients of keel type C-ADR with heterotopic ossification underwent posterior laminoforaminotomy and fusion. Two patients underwent combined procedures due to infection or severe subsidence and osteolysis. At the 2-year follow-up, neck (7.3 vs 1.6) and arm (7.0 vs 1.3) visual analog scales and Neck Disability Index score (46.7 vs 16.32) were improved (all, p < 0.05). According to Odom's criteria, 86% of the patients were satisfied and 91% achieved solid fusion. No major complications developed except for transient dysphagia in 6 patients (29%). CONCLUSIONS: In this small case series, revision surgeries provided successful outcomes in failed C-ADR without major complications. Careful patient selection and meticulous surgical techniques are important to avoid disappointing clinical outcome or even failure of C-ADR. LEVEL OF EVIDENCE: Level IV, Therapeutic study.
Full Text
http://www.sciencedirect.com/science/article/pii/S1017995X16302814
DOI
10.1016/j.aott.2016.04.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
석경수(Suk, Kyung Soo) ORCID logo https://orcid.org/0000-0003-0633-2658
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/153087
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