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Catastrophic delayed cervical arthroplasty failure: illustrative case.

Diego A Carrera, Christian B Ricks

    Journal of Neurosurgery. Case Lessons
    |October 9, 2022
    PubMed
    Summary

    A rare M6-C cervical disc replacement failure caused spinal cord injury years after surgery. Prompt revision surgery led to an excellent patient recovery, highlighting the need for vigilance.

    Keywords:
    M6-C prosthesiscase reportcervical degenerative disc diseasecervical disc arthroplasty

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    Area of Science:

    • Spine Surgery
    • Biomedical Engineering
    • Neurology

    Background:

    • Cervical disc replacement (CDR) is a common alternative to fusion for cervical disc disease.
    • Limited data exist on the long-term fatigue and failure of CDR implants.
    • This report details a unique failure of an M6-C prosthesis leading to spinal cord injury.

    Purpose of the Study:

    • To report a previously undescribed failure mode of the M6-C cervical disc prosthesis.
    • To highlight the potential for catastrophic outcomes from implant fatigue.
    • To emphasize the importance of patient counseling and adverse event reporting.

    Main Methods:

    • A case study of a 49-year-old female patient with a history of cervical degenerative disease and M6-C arthroplasty.
    • Presentation of symptoms 9 years post-implantation following a minor fall.
    • Review of imaging findings, surgical intervention details, and patient outcome.

    Main Results:

    • Imaging revealed a fractured M6-C arthroplasty penetrating the spinal cord.
    • Revision surgery identified a ruptured annulus and removed a metallic fragment from the spinal cord.
    • The patient experienced an excellent recovery with neurological symptom resolution after corpectomy and reconstruction.

    Conclusions:

    • Fatigue-related failures of CDR implants, though infrequent, can have severe consequences.
    • Further discussion, enhanced patient counseling, and a dedicated patient registry are recommended.
    • This case underscores the critical need to monitor long-term implant performance and patient safety.