Cervical artificial disc extrusion after a paragliding accident

Area of Science:

• Spine surgery
• Biomaterials engineering
• Orthopedic biomechanics

Background:

• Cervical total disc replacement (TDR) offers an alternative to anterior cervical discectomy and fusion (ACDF).
• Implant failure and migration are infrequent, typically occurring years post-surgery.
• This study details a rare instance of cervical artificial disc (CAD) extrusion.

Observation:

• A 33-year-old female experienced neck pain post-paragliding accident, 14 months after C4-C5 CAD implantation.
• X-rays revealed a 4 mm anterior protrusion of the CAD.
• The patient underwent CAD removal and subsequent anterior fusion.

Findings:

• Cervical artificial disc (CAD) extrusion is an uncommon complication.
• The extrusion in this case is attributed to inadequate osseous integration.
• Analysis of literature cases and device testing are discussed.

Implications:

• Patients should avoid high-risk activities post-TDR to prevent implant dislodgement.
• Future research should aim to improve osseous integration at the implant interface.
• Minimizing heterotopic ossification is also a key consideration for device design.