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Revision Surgery for a Failed Artificial Disc

 Kwang Ryeol Kim  ;  Dong Kyu Chin  ;  Keun Su Kim  ;  Yong Eun Cho  ;  Dong Ah Shin  ;  Keung Nyun Kim  ;  Sung Uk Kuh 
 YONSEI MEDICAL JOURNAL, Vol.62(3) : 240-248, 2021-03 
Journal Title
Issue Date
Adult ; Cervical Vertebrae / diagnostic imaging ; Cervical Vertebrae / surgery ; Disability Evaluation ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Pain Measurement ; Pain, Postoperative / etiology ; Reoperation* ; Retrospective Studies ; Total Disc Replacement* ; Treatment Outcome ; Visual Analog Scale ; Young Adult
Artificial disc replacement ; cervical ; diskectomy ; fusion ; revision surgery
Purpose: This study aimed to present our experience with failures in C-TDR and revision surgery outcomes. Materials and methods: We retrospectively examined patients who underwent revision surgery due to the failure of C-TDR between May 2005 to March 2019. Thirteen patients (8 males and 5 females) were included in this study. The mean age was 46.1 years (range: 22-61 years), and the average follow-up period was 19.5 months (range: 12-64 months). The outcome measures of pre- and post-operative neck and arm pain using a visual analogue scale (VAS) and functional impairment were assessed using a modified Japanese Orthopedic Association (JOA) scale and the Neck Disability Index (NDI). Results: The main complaints of patients were posterior neck pain (77%), radiculopathy (62%), and/or myelopathy (62%). The causes of failure of C-TDR were improper indications for the procedure, osteolysis and mobile implant use, inappropriate techniques, and postoperative infection. The most common surgical level was C5-6, followed by C4-5. After revision surgery, the neck and arm pain VAS (preoperative vs. postoperative: 5.46 vs. 1.31; 4.86 vs. 1.08), a modified JOA scale (14.46 vs. 16.69), and the NDI (29.77 vs. 9.31) scores were much improved. Conclusion: C-TDR is good surgical option. However, it is very important to adhere to strict surgical indications and contraindications to avoid failure of C-TDR. The results of reoperations were good regardless of the approach. Therefore, various reoperation options could be considered in patients with failed C-TDR.
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1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Kim, Keung Nyun(김긍년)
Shin, Dong Ah(신동아) ORCID logo https://orcid.org/0000-0002-5225-4083
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
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