Failures in Cervical Disc Arthroplasty: A Narrative Review of Failure Modes and Clinical Implications

» Cervical disc arthroplasty (CDA) offers a potential alternative for patients with degenerative disc disease, improving long-term outcomes such as preserved range of motion, decreased incidence of adjacent segment degeneration, and lower morbidity.» CDA offers potential advantages over anterior cervical discectomy and fusion in regard to length of stay, cost, and routine discharge, but the motion-preserving design may introduce novel complications and failure modalities that are poorly understood.» Complications of CDA may include heterotopic ossification, decreased range of motion, persistent or worsening pain, unintended fusion, and permanent neurologic deficit.» Preventing CDA failures begins with careful recognition of contraindications such as cervical instability, osteoporosis or osteopenia, previous surgery at the surgical level(s), and extensive facet joint arthropathy.» Complication profiles associated with CDAs vary in accord with device characteristics, highlighting a potential need for matching prosthesis design with patient-specific factors.