Patient outcomes and surgical strategies in revision cervical arthroplasty following M6-C™ disc-related osteolysis.

IF 2.6 3区医学 Q2 CLINICAL NEUROLOGY

European Spine Journal Pub Date : 2025-05-28 DOI:10.1007/s00586-025-08926-6

Matthew Scott-Young, David Nielsen, Sukhman Riar, Evelyne Rathbone

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引用次数: 0

Abstract

Purpose: Periprosthetic osteolysis from the M6-C™ Artificial Cervical Disc (Orthofix, Lewisville, Texas) has become a significant issue, sometimes requiring revision spine surgery (RSS). This study evaluates patient-reported outcome measures (PROMs) and revision strategies for managing device-related wear and osteolysis.

Methods: PROMs, including the Visual Analogue Scale (VAS) for neck/arm pain and the Neck Disability Index (NDI), were analyzed at pre-index surgery (T1), pre-RSS (T2), and final follow-up (T3). Osteolysis severity was graded radiographically. A control group who underwent primary M6-C cervical total disc replacement (CTDR) without RSS was included for comparison.

Results: Of 53 patients with M6-C CTDR, 19 (35.9%) required RSS due to osteolysis. Osteolysis grades included Grade 1 (4 patients), Grade 2 (7 patients), Grade 3 (3 patients), and Grade 4 (5 patients). Revision strategies included removal and anterior fusion, requiring vertebrectomy for Grade 4 cases; revisions to a different CTDR prosthesis were reserved for Grades 1-3. The RSS group showed significant VAS neck pain improvement at T3 (mean = 36.2 points, p < 0.001), exceeding the minimum clinically important difference (MCID). However, VAS arm pain and NDI did not meet MCID thresholds. The control group showed clinically significant improvements across all PROMs. At T2, the RSS group had a higher disability (NDI, p = 0.027) than the controls.

Conclusion: Revision surgery for M6-C osteolysis improves neck pain, not arm pain or disability. Early detection and tailored revision strategies are crucial to optimize patient outcomes and mitigate osteolysis-related disability.

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M6-C™椎间盘相关性骨溶解术后颈椎翻修置换术的患者预后和手术策略

目的：M6-C™人工颈椎间盘假体周围骨溶解（Orthofix, Lewisville, Texas）已成为一个重要问题，有时需要脊柱翻修手术（RSS）。本研究评估了患者报告的结果测量（PROMs）和管理器械相关磨损和骨溶解的修订策略。方法：在手术前（T1）、rss前（T2）和最终随访（T3）分析PROMs，包括颈/臂疼痛视觉模拟量表（VAS）和颈部残疾指数（NDI）。骨溶解严重程度影像学分级。对照组接受初级M6-C颈椎全椎间盘置换术（CTDR），无RSS。结果：53例M6-C CTDR患者中，19例（35.9%）因骨溶解需要RSS。骨溶解等级包括1级（4例）、2级（7例）、3级（3例）和4级（5例）。翻修策略包括切除和前路融合，4级病例需要椎体切除术；为1-3级保留对不同CTDR假体的修订。RSS组在T3时VAS颈部疼痛明显改善（平均= 36.2分，p）。结论：M6-C骨溶解翻修手术改善了颈部疼痛，而不是手臂疼痛或残疾。早期发现和量身定制的翻修策略对于优化患者预后和减轻骨溶解相关残疾至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Spine Journal 医学-临床神经学

CiteScore

4.80

自引率

10.70%

发文量

373

审稿时长

2-4 weeks

期刊介绍： "European Spine Journal" is a publication founded in response to the increasing trend toward specialization in spinal surgery and spinal pathology in general. The Journal is devoted to all spine related disciplines, including functional and surgical anatomy of the spine, biomechanics and pathophysiology, diagnostic procedures, and neurology, surgery and outcomes. The aim of "European Spine Journal" is to support the further development of highly innovative spine treatments including but not restricted to surgery and to provide an integrated and balanced view of diagnostic, research and treatment procedures as well as outcomes that will enhance effective collaboration among specialists worldwide. The “European Spine Journal” also participates in education by means of videos, interactive meetings and the endorsement of educative efforts. Official publication of EUROSPINE, The Spine Society of Europe