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Revision Surgeries at the Index Level After Cervical Disc Arthroplasty - A Systematic Review

Neurospine 2021년 18권 1호 p.34 ~ 44
Joaquim Andrei Fernandes, Lee Nathan J., Riew K. Daniel,
소속 상세정보
 ( Joaquim Andrei Fernandes ) - University of Campinas Department of Neurosurgery
 ( Lee Nathan J. ) - Columbia University Medical Center Department of Orthopedics
 ( Riew K. Daniel ) - Columbia University Medical Center Department of Orthopedics

Abstract


Objective: To perform a systematic literature review on revision surgeries at the index level after cervical disc arthroplasty (CDA) failure.

Methods: A systematic literature review was performed according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Prospective studies on patients who required a secondary surgery after CDA failure were included for analysis. The minimum follow-up for these studies was 5 years.

Results: Out of 864 studies in the original search group, a total of 20 studies were included. From a total of 4,087 patients, 161 patients required a reoperation at the index level. A total of 170 surgeries were performed, as some patients required multiple surgeries. The most common secondary procedures were anterior cervical discectomy and fusion (ACDF) (68%, N = 61) and posterior cervical fusion (15.5%, N = 14), followed by other reoperation (13.3%, N = 12). The associated outcomes for those who required a revision surgery were rarely mentioned in the included literature.

Conclusion: The long-term revision rate at the index level of failed CDA surgery was 3.9%, with a minimum 5-year follow-up. ACDF was the most commonly performed procedure to salvage a failed CDA. Some patients who required a new surgery after CDA failure may require a more extensive salvage procedure and even subsequent surgeries.

키워드

Cervical arthroplasty; Index level; Revision; Reoperations; Anterior cervical disc replacement

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