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Osteolysis after cervical disc arthroplasty.

Andrei Fernandes Joaquim1, Nathan J Lee2, Ronald A Lehman2

  • 1Department of Neurosurgery, University of Campinas (UNICAMP), Campinas, SP, Brazil. andjoaquim@yahoo.com.

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|September 1, 2020
PubMed
Summary

Osteolysis after cervical disc arthroplasty (CDA) is common, often asymptomatic, and typically does not require revision surgery. Bone loss can occur early or late after CDA, with varying incidence rates reported in the literature.

Keywords:
Anterior cervical disc replacementAnterior cervical fusionBone lossCervical arthroplastyCervical degenerative diseaseCervical spondylosisOsteolysisPosterior cervical fusion

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Area of Science:

  • Spine surgery
  • Orthopedic surgery
  • Biomaterials

Background:

  • Cervical disc arthroplasty (CDA) is a prevalent surgical option for degenerative disc disease.
  • Osteolysis is a potential complication following CDA, with limited existing literature.
  • Understanding osteolysis is crucial for patient management and surgical outcomes.

Purpose of the Study:

  • To systematically review the incidence, causes, consequences, and treatment of osteolysis after CDA.
  • To provide a comprehensive overview of osteolysis as a complication of cervical disc arthroplasty.
  • To synthesize current evidence on osteolysis following CDA.

Main Methods:

  • A systematic literature review adhering to PRISMA guidelines was conducted.
  • Included studies focused on the etiology, incidence, and management of osteolysis post-CDA.
  • Nine studies were analyzed, categorized into large case series and case reports.

Main Results:

  • The incidence of asymptomatic osteolysis ranged from 8% to 64%, with most studies reporting 44-64%.
  • Severe bone loss exposing the implant occurred in less than 4% of patients.
  • Osteolysis could manifest early or late post-surgery, and symptomatic cases often necessitated revision to fusion.

Conclusions:

  • Osteolysis is a frequent complication of CDA, but typically presents mildly and asymptomatically.
  • Most patients with osteolysis after CDA do not require surgical revision.
  • The varied timing of osteolysis suggests diverse underlying etiologies.