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Anterior bone loss after cervical disc replacement: A systematic review
Xiao-Fei Wang1, Yang Meng1, Hao Liu2
1Department of Orthopaedic Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China.
World Journal of Clinical Cases
|December 3, 2020
Summary
Anterior bone loss (ABL) is common after cervical disc replacement (CDR), affecting over 40% of patients. This complication can lead to implant issues and neck pain, requiring careful consideration.
Area of Science:
- Spine surgery
- Orthopedics
- Biomaterials
Background:
- Anterior bone loss (ABL) is a frequently overlooked condition following cervical disc replacement (CDR).
- The nature of ABL, whether a radiological finding or a complication, remains debated.
- Existing research often focuses on specific artificial disc types, limiting a comprehensive understanding of ABL.
Purpose of the Study:
- To determine the prevalence of ABL after CDR.
- To investigate the clinical impacts and potential risk factors associated with ABL.
- To synthesize current knowledge on ABL following cervical disc arthroplasty.
Main Methods:
- Systematic literature search of PubMed, Cochrane Library, and Embase databases.
- Inclusion of studies reporting on the prevalence and impacts of ABL after cervical disc replacement.
- Narrative synthesis of data extracted from six eligible studies.
Main Results:
- Six studies involving 440 patients and 536 segments were analyzed.
- The overall prevalence of ABL was 41.84%, with a wide range (3.13%–91.89%) across studies.
- ABL onset occurred within 6 months and resolved by 12 months post-surgery; severe cases correlated with kyphosis, implant subsidence, and neck pain.
Conclusions:
- Anterior bone loss is a prevalent complication after cervical disc replacement.
- Potential mechanisms include stress concentration and damage to vascular supply.
- ABL is associated with adverse outcomes such as persistent neck pain and implant subsidence, necessitating its classification as a complication.
