Vertebral artery injury following cervical disc arthroplasty – A systematic review

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience Pub Date : 2025-06-20 DOI:10.1016/j.jocn.2025.111383

Gonzalo F. Del Rio Montesinos , Lancelot Benn , Christopher P. Bellaire , Addisu Mesfin

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引用次数: 0

Abstract

Background

Cervical Disc Arthroplasty (CDA) treats cervical disc degeneration while preserving spinal mobility. Although effective, the procedure poses a risk to the Vertebral Artery (VA), which transverses the foramina of C2-C6 and enters the skull via the foramen magnum. While the vertebral artery injury (VAI) is rare, it can lead to serious complications. This review analyses VAI during CDA by examining anatomical variations, surgeon experience, and strategies for prevention, diagnosis, and management.

Methods

The articles chosen were from 06/30/2000 to 04/30/2025 and sourced from PubMed, Science Direct, and Web of Science. The keywords were cervical, cervical disc, vertebral artery, vertebral artery injury, disc arthroplasty, and degenerative disc.

Results

Anatomic VA variations occurred in 7.6 % of 250 individuals. The anterior approach in CDA shows a 0.4 % VAI rate. Preoperative MRI and postoperative imaging should be widely used to assess VA course. Surgeon experience of <300 cases had a 0.33 % VAI prevalence versus 0.06 % in those with >300. Although CDA has been used in Europe since 1960 s, it was FDA approved in 2007. Of 11 approved devices, eight reported blood loss, two vascular injuries and one cerebrovascular bleed, yet no VAI is listed a complication. Only two published case reports document VAI during CDA. Stenting has a proved 97 % success rate but may require reintervention. The rise in CDA use of 190 % from 2007 to 2013 suggest a likely increase in reported VAI cases.

Conclusion

VAI must be considered when approaching a CDA due the higher prevalence of these procedures being implemented. Anatomic variations, Physician Experience, and preventative and treatment management are factors to consider in VAI.

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颈椎间盘置换术后椎动脉损伤-系统综述

背景：颈椎间盘置换术（CDA）在保持脊柱活动的同时治疗颈椎间盘退变。虽然有效，但该手术对椎动脉（VA）有风险，该椎动脉穿过C2-C6椎间孔并通过枕骨大孔进入颅骨。虽然椎动脉损伤（VAI）是罕见的，它可以导致严重的并发症。本文通过分析CDA的解剖变异、外科医生经验以及预防、诊断和治疗策略来分析VAI。方法选取2000年6月30日~ 2025年4月30日的文献，文献来源为PubMed、Science Direct和Web of Science。关键词：颈椎、颈椎间盘、椎动脉、椎动脉损伤、椎间盘置换术、退变性椎间盘。结果在250例个体中，发生了7.6%的VA原子变异。CDA前路的VAI率为0.4%。术前MRI和术后影像学应广泛应用于评估房颤病程。300例患者的VAI患病率为0.33%，而300例患者的VAI患病率为0.06%。虽然CDA早在20世纪60年代就在欧洲使用，但直到2007年才获得FDA的批准。在11个批准的器械中，8个报告了失血，2个血管损伤和1个脑血管出血，但没有VAI被列为并发症。只有两份已发表的病例报告记录了CDA期间的VAI。支架植入术的成功率为97%，但可能需要再次介入。从2007年到2013年，CDA使用量增加了190%，这表明报告的VAI病例可能增加。结论在进行CDA时应考虑vai，因为这些手术的患病率较高。解剖差异、医师经验、预防和治疗管理是VAI需要考虑的因素。

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

Journal of Clinical Neuroscience 医学-临床神经学

CiteScore

4.50

自引率

0.00%

发文量

402

审稿时长

40 days

期刊介绍： This International journal, Journal of Clinical Neuroscience, publishes articles on clinical neurosurgery and neurology and the related neurosciences such as neuro-pathology, neuro-radiology, neuro-ophthalmology and neuro-physiology. The journal has a broad International perspective, and emphasises the advances occurring in Asia, the Pacific Rim region, Europe and North America. The Journal acts as a focus for publication of major clinical and laboratory research, as well as publishing solicited manuscripts on specific subjects from experts, case reports and other information of interest to clinicians working in the clinical neurosciences.