Anterior Bone Loss in Cervical Disc Arthroplasty

Area of Science:

• Spine surgery
• Orthopedic research
• Biomaterials science

Background:

• Anterior bone loss (ABL) is a recognized complication of cervical disc arthroplasty (CDA).
• The etiology and clinical significance of ABL following CDA are not well understood.
• This study aims to elucidate the natural history of ABL and propose a classification system.

Purpose of the Study:

• To characterize the natural history of anterior bone loss (ABL) in patients undergoing cervical disc arthroplasty (CDA).
• To introduce a novel classification system for assessing ABL.
• To evaluate the relationship between ABL and clinical outcomes.

Main Methods:

• Retrospective analysis of 146 patients with non-keeled CDA.
• Radiographic assessment of ABL at multiple time points up to 5 years post-surgery.
• Evaluation of Visual Analog Scale pain scores and Neck Disability Index.

Main Results:

• Anterior bone loss (ABL) was observed in 57.1% of cervical disc replacements (CDRs).
• ABL typically presented within 3 months, showed a benign, non-progressive course, and improved after initial resorption.
• No correlation was found between ABL severity and pain or functional outcomes; no revisions were performed due to ABL.

Conclusions:

• Anterior bone loss (ABL) is a frequent finding after cervical disc arthroplasty (CDA), occurring in over half of cases.
• The condition is generally mild, appears early, and demonstrates a stable radiographic course after one year.
• ABL does not negatively impact clinical outcomes or necessitate revision surgery, suggesting a need for clinical consideration during CDA patient management.