719 - Clinical Failure after Cervical Total Disc Arthroplasty Causing Sympto...

#719 Clinical Failure after Cervical Total Disc Arthroplasty Causing Symptomatic Adjacent Segment Degeneration and Spontaneous Arthrodesis at the Level of Arthroplasty: A Case Report

Arthroplasty

Poster Presented by: S.H. Yoon

Author(s):

S.H. Yoon (1)

(1) The Armed Forces Capital Hospital, Neurosurgery, Seongnam-si, Korea, Republic of

Abstract

Objectives: To show a instructive case of clinical failure after cervical total disc arthroplasty causing symptomatic adjacent segment degeneration and spontaneous arthrodesis at the level of arthroplasty.

Materials and Methods: A 53-year-old man suffered from wrist drop and weakness in right hand grasp with thenar muscle atrophy visited our outpatient clinic. He underwent cervical arthroplasty 8 years before visiting our clinic. Preoperative Images(8 years ago) showed segmental ossification of posterior longitudinal ligament around C4-C5 disc space. Consecutive MRI and CT after recent chief complaint spinal cord atrophy and spontaneous arthrodesis at the level of cervical arthroplasty (C4-C5 disc space) was shown and adjacent degenerative changes such as herniated disc and foraminal stenosis at C5-6 and C6-C7 disc space were noticed. Electrophysiologic examination revealed right chronic C7 radiculopathy.

Results: Anterior cervical discectomy and fusion with foraminotomy at C5-6 & C6-7 was performed. His wrist drop and hand in right hand grasp has improved slowly since about a year and half after the operation.

Conclusion: Under inadequate indication of cervical total disc replacement, the operation resulted in failure of segmental motion preservation and failed to prevent from stopping adjacent segment problem.