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Revision Surgery for a Failed Artificial Disc

Yonsei Medical Journal 2021년 62권 3호 p.240 ~ 248
김광렬, 신동규, 김근수, 조용은, 신동아, 김긍년, 구성욱,
소속 상세정보
김광렬 ( Kim Kwang-Ryeol ) - Catholic Kwandong University College of Medicine International St. Mary’s Hospital Department of Neurosurgery
신동규 ( Chin Dong-Kyu ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Neurosurgery
김근수 ( Kim Keun-Su ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Neurosurgery
조용은 ( Cho Yong-Eun ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Neurosurgery
신동아 ( Shin Dong-Ah ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
김긍년 ( Kim Keung-Nyun ) - Yonsei University College of Medicine Severance Hospital Department of Neurosurgery
구성욱 ( Kuh Sung-Uk ) - Yonsei University College of Medicine Gangnam Severance Hospital Department of Neurosurgery

Abstract


Purpose: This study aimed to present our experience with failures in C-TDR and revision surgery outcomes.

Materials and Methods: We retrospectively examined patients who underwent revision surgery due to the failure of C-TDR between May 2005 to March 2019. Thirteen patients (8 males and 5 females) were included in this study. The mean age was 46.1 years (range: 22?61 years), and the average follow-up period was 19.5 months (range: 12?64 months). The outcome measures of pre- and post-operative neck and arm pain using a visual analogue scale (VAS) and functional impairment were assessed using a modified Japanese Orthopedic Association (JOA) scale and the Neck Disability Index (NDI).

Results: The main complaints of patients were posterior neck pain (77%), radiculopathy (62%), and/or myelopathy (62%). The causes of failure of C-TDR were improper indications for the procedure, osteolysis and mobile implant use, inappropriate techniques, and postoperative infection. The most common surgical level was C5?6, followed by C4?5. After revision surgery, the neck and arm pain VAS (preoperative vs. postoperative: 5.46 vs. 1.31; 4.86 vs. 1.08), a modified JOA scale (14.46 vs. 16.69), and the NDI (29.77 vs. 9.31) scores were much improved.

Conclusion: C-TDR is good surgical option. However, it is very important to adhere to strict surgical indications and contraindications to avoid failure of C-TDR. The results of reoperations were good regardless of the approach. Therefore, various reoperation options could be considered in patients with failed C-TDR.

키워드

Artificial disc replacement; cervical; diskectomy; fusion; revision surgery

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