Clinical Spine Surgery最新文献

{"title":"Long-term Outcomes After Adult Spinal Deformity Surgery Using Lateral Interbody Fusion: Short Versus Long Fusion.","authors":"Shunji Tsutsui, Hiroshi Hashizume, Hiroshi Iwasaki, Masanari Takami, Yuyu Ishimoto, Keiji Nagata, Hiroshi Yamada","doi":"10.1097/BSD.0000000000001583","DOIUrl":"10.1097/BSD.0000000000001583","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>To investigate long-term outcomes after short or long fusion for adult spinal deformity using lateral interbody fusion.</p><p><strong>Summary of background data: </strong>Lateral interbody fusion is commonly used in adult spinal deformity surgery. Favorable short-term outcomes have been reported, but not long-term outcomes. Lateral interbody fusion with strong ability to correct deformity may allow the selection of short fusion techniques.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed adults who underwent this surgery with a minimum of 5 years of follow-up. Short fusion with the uppermost instrumented vertebra in the lumbar spine was performed in patients without degenerative changes at the thoracolumbar junction (S-group); others underwent long fusion with the uppermost instrumented vertebra in the thoracic spine (L-group). We assessed radiographic and clinical outcomes.</p><p><strong>Results: </strong>Short fusion was performed in 29 of 54 patients. One patient per group required revision surgery. Of the remainder, with similar preoperative characteristics and deformity correction between groups, correction loss (pelvic incidence-lumbar lordosis, P =0.003; pelvic tilt, P =0.005; sagittal vertical axis, P ˂0.001) occurred within 2 years postoperatively in the S-group, and sagittal vertical axis continued to increase until the 5-year follow-up ( P =0.021). Although there was a significant change in Oswestry disability index in the S-group ( P =0.031) and self-image of Scoliosis Research Society 22r score in both groups ( P =0.045 and 0.02) from 2- to 5-year follow-up, minimum clinically important differences were not reached. At 5-year follow-up, there was a significant difference in Oswestry Disability Index ( P =0.013) and Scoliosis Research Society 22r scores (function: P =0.028; pain: P =0.003; subtotal: P =0.006) between the groups, but satisfaction scores were comparable and Oswestry Disability Index score (29.8%) in the S-group indicated moderate disability.</p><p><strong>Conclusions: </strong>Health-related quality of life was maintained between 2- and 5-year follow-up in both groups. Short fusion may be an option for patients without degenerative changes at the thoracolumbar junction.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139746301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographical and Specialty-specific Variation in the Utilization of Laminoplasty for Cervical Myelopathy.","authors":"Aymen Alqazzaz, Thompson Zhuang, Bijan Dehghani, Stephen R Barchick, Ali K Ozturk, Amrit S Khalsa, David S Casper","doi":"10.1097/BSD.0000000000001617","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001617","url":null,"abstract":"<p><strong>Study design: </strong>Level IV retrospective cohort study.</p><p><strong>Objectives: </strong>Despite the positive outcomes associated with laminoplasty, there is significant surgeon variability in the use of laminoplasty for cervical myelopathy in the United States. In this study, we explored how geographic and specialty-specific differences may influence the utilization of laminoplasty to treat cervical myelopathy.</p><p><strong>Background: </strong>We queried the Mariner 157 database (PearlDiver, Inc.), a national administrative claims database containing diagnostic, procedural, and demographic records from over 157 million patients from 2010 to 2021.</p><p><strong>Patients and methods: </strong>Using the International Classification of Diseases 10th Revision/International Classification of Diseases Ninth Revision and Current Procedural Terminology codes, we identified all patients with a diagnosis of cervical myelopathy who had undergone multilevel posterior cervical decompression and fusion (PCDF) or laminoplasty. We further analyzed patients' demographics, comorbidities, geographical location, and specialty of the surgeon (neurosurgery or orthopedic spine surgery).</p><p><strong>Results: </strong>There were 34,432 patients with a diagnosis of cervical myelopathy, of which 4,033 (11.7%) underwent laminoplasty and 30,399 (88.3%) underwent multilevel PCDF. Northeast, South, and West regions had lower percentages of laminoplasty utilization compared with the Midwest in terms of total case mix between laminoplasty and PCDF. In addition, 2,300 (57.0%) of the laminoplasty cases were performed by orthopedic spine surgeons compared with 1,733 (43.0%) by neurosurgeons. Temporal trends in laminoplasty utilization were stable for orthopedic surgeons, whereas laminoplasty utilization decreased over time between 2010 and 2021 for neurosurgeons (P < 0.001).</p><p><strong>Conclusions: </strong>Utilization of laminoplasty in the United States is not well defined. Our results suggest a geographical and training-specific variation in the utilization of laminoplasty. Surgeons with orthopedic training were more likely to perform laminoplasty compared with surgeons with a neurosurgery training background. In addition, we found greater utilization of laminoplasty in the Midwest compared with other regions.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Minimal Clinically Important Difference and Patient Acceptable Symptom State Relate to Patient Expectations and Satisfaction in Spine Surgery: A Review.","authors":"Ebubechi Adindu, Devender Singh, Matthew Geck, John Stokes, Eeric Truumees","doi":"10.1097/BSD.0000000000001672","DOIUrl":"10.1097/BSD.0000000000001672","url":null,"abstract":"<p><p>This narrative review seeks to enhance our comprehension of how Minimal Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS) values in established Patient Reported Outcome Measures (PROMs) for spine surgery correspond with patient preoperative expectations and postoperative satisfaction. Through our literature search, we found that both MCID and PASS serve as dependable indicators of patient expectations. However, MCID may be more susceptible to a floor effect. This implies that PASS may offer a more accurate reflection of how patients anticipate surgery to address their symptoms. Nevertheless, it is crucial to recognize that achieving MCID or PASS may not be an absolute prerequisite for patients to be satisfied with their treatment.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cervical Intervertebral Foramen","authors":"Jesse Caballo, Austin Darden, Shahjehan Ahmad, Barrett Boody","doi":"10.1097/bsd.0000000000001681","DOIUrl":"https://doi.org/10.1097/bsd.0000000000001681","url":null,"abstract":"Study Design: This is an evidence-based narrative review article. Objective: We hope to provide a primer on cervical intervertebral foramen (cIVF) anatomy for spine surgeons, interventionalists, and physiatrists who regularly treat cervical spine pathology, and encourage further exploration of this topic. Background: This corridor for exiting cervical nerve roots is characterized by its intricate microanatomy involving ligamentous, nervous, and vascular structures. Degenerative changes such as facet hypertrophy and disc herniations alter these relationships, potentially leading to nerve root compression and cervical radiculopathy. Methods: This review synthesizes existing knowledge on the cIVF. Key imaging, cadaveric, and clinical studies serve as a foundation for this anatomic review. Results: We explore topics such as dynamic changes that affect foraminal size and their implications for nerve root compression, the relationship of the dorsal root ganglion to the cervical foramen, and the function and clinical significance of foraminal ligaments, arteries, and veins. Conclusions: Changes in the cIVF are frequently the basis of cervical degenerative pathologies. A comprehensive understanding of its microanatomical structure will allow the practitioner to better treat the underlying disease process causing their symptoms and signs.","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Utility of Magnetic Resonance Imaging-based Vertebral Bone Quality Scores as a Predictor of Cage Subsidence Following Transforaminal and Posterior Lumbar Interbody Fusion.","authors":"Ara Khoylyan, Mina Y Girgis, Alex Tang, Frank Vazquez, Tan Chen","doi":"10.1097/BSD.0000000000001682","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001682","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective study.</p><p><strong>Objectives: </strong>The objectives were to determine whether vertebral bone quality (VBQ) scores are associated with interbody cage subsidence following transforaminal (TLIF) and posterior (PLIF) lumbar interbody fusions and whether there is a clinically sensitive threshold for subsidence.</p><p><strong>Background: </strong>Interbody cage subsidence following lumbar fusion is a complication that can generate poor surgical outcomes. Prior research has correlated cage subsidence with bone mineral density. VBQ scores derived from magnetic resonance imaging (MRI) have been proposed as a tool for measuring bone mineral density, offering a potential new and convenient preoperative risk assessment tool for subsidence.</p><p><strong>Methods: </strong>The study involved patients undergoing single-level PLIF or TLIF between 2007 and 2022. Exclusions were for nondegenerative diagnoses, multilevel/revision surgeries, inadequate radiographs, missing immediate postoperative radiographs, and preoperative MRI studies older than 1 year. VBQ was calculated at L1-L4 from preoperative T1-weighted MRI images. Subsidence was assessed by changes in disc height (DH; >2 mm difference) and segmental lordosis (SL; >5 degrees difference) between immediate weight-bearing postoperative and latest postoperative lateral radiographs. Statistical analysis included descriptive and inferential statistics.</p><p><strong>Results: </strong>Subsidence was observed in 27% (SL parameter) and 47% (DH parameter) of 51 total patients. VBQ scores were significantly associated with cage subsidence based on both SL (odds ratio = 7.750, P = 0.012; correlation coefficient = 0.382, P = 0.006) and DH (odds ratio = 4.074, P = 0.026; correlation coefficient = 0.258, P = 0.057) in the combined TLIF/PLIF cohorts. In the cohort of 36 patients undergoing TLIF, a VBQ of 2.70 yielded 100.0% sensitivity and 46.2% specificity in detecting subsidence with SL measurement (area under the curve = 0.812, P < 0.001) and 86.7% sensitivity and 47.6% specificity with the DH measurement (area under the curve = 0.692, P = 0.033).</p><p><strong>Conclusions: </strong>We found that MRI-based VBQ scores are effective predictors of cage subsidence following TLIF surgery. A VBQ score of 2.70 demonstrated a reliable model and high sensitivity for doing so, identifying a potential clinical threshold for preoperative subsidence risk assessment.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforaminal Versus Lateral Interbody Fusions for Treatment of Adjacent Segment Disease in the Lumbar Spine","authors":"Prashant V. Rajan, Mark Megerian, Ansh Desai, Penelope N. Halkiadakis, Nicholas Rabah, Michael D. Shost, Bilal Butt, James E. Showery, Zachary Grabel, Dominic W. Pelle, Jason W. Savage","doi":"10.1097/bsd.0000000000001673","DOIUrl":"https://doi.org/10.1097/bsd.0000000000001673","url":null,"abstract":"Study Design: Retrospective comparative study. Objective: This study compared outcomes for patients managed with a lateral approach to interbody fusion [lateral (LLIF) or oblique (OLIF)] versus a posterior (PLIF) or transforaminal interbody fusion (TLIF) for treatment of adjacent segment disease (ASD) above or below a prior lumbar fusion construct. Summary of Background Data: No study has compared outcomes of lateral approaches to more traditional posterior approaches for the treatment of ASD. Methods: Retrospective review was performed of patients who underwent single-level lateral or posterior approaches for lumbar interbody fusion for symptomatic ASD between January 2010 and December 2021. Exclusion criteria included skeletal immaturity (age below 18 y old) and surgery indication for malignancy or infection. Patient demographics, medical comorbidities, operative details, postoperative complications, and revision surgery profiles were collected for all patients. Standard descriptive statistics were used to summarize data. Comparative statistical analyses were performed using Statistical Package for the Social Sciences (Version 28.0.1.0; Chicago, IL). Results: A total of 152 patients (65±10 y) were included in the study with a mean duration of follow-up of 1.6±1.4 years. The cohort included 123 PLIF/TLIF (81%), 18 LLIF (12%), 11 OLIF (7%). TLIF/PLIF experienced greater mean operative time (210±62 min vs. 184±80 OLIF/105±64 LLIF, <jats:italic toggle=\"yes\">P</jats:italic>&lt;0.001) and estimated blood loss (414±254 mL vs. 49±29 OLIF/36±33 LLIF, <jats:italic toggle=\"yes\">P</jats:italic>&lt;0.001). No significant difference in rate of postoperative complications. Postoperative radicular pain was significantly greater in OLIF (7, 64%) and LLIF (7, 39%) compared with PLIF/TLIF (16, 13%), <jats:italic toggle=\"yes\">P</jats:italic>&lt;0.001. No statistically significant difference in health care utilization was noted between the groups. Conclusion: Lateral fusions to treat ASD demonstrated no significantly different risk of complication compared with posterior approaches. Our study demonstrated significantly increased operative time and estimated blood loss for the posterior approach and an increased risk of radicular pain from manipulation/retraction of psoas following lateral approaches. Level of Evidence: Level III.","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142209856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacologic Therapy for Spinal Cord Injury","authors":"Brandon A. Sherrod, Ken Porche, Chad K. Condie, Andrew T. Dailey","doi":"10.1097/bsd.0000000000001695","DOIUrl":"https://doi.org/10.1097/bsd.0000000000001695","url":null,"abstract":"Neuroprotective strategies aimed at preventing secondary neurologic injury following acute spinal cord injury remain an important area of clinical, translational, and basic science research. Despite recent advancement in the understanding of basic mechanisms of primary and secondary neurologic injury, few pharmacologic agents have shown consistent promise in improving neurologic outcomes following SCI in large randomized clinical trials. The authors review the existing literature and clinical guidelines for pharmacologic therapy investigated for managing acute SCI, including corticosteroids, GM-1 ganglioside (Sygen), Riluzole, opioid antagonists, Cethrin, minocycline, and vasopressors for mean arterial pressure augmentation. Therapies for managing secondary effects of SCI, such as bradycardia, are discussed. Current clinical trials for pharmacotherapy and cellular transplantation following acute SCI are also reviewed. Despite the paucity of current evidence for clinically beneficial post-SCI pharmacotherapy, future research efforts will hopefully elucidate promising therapeutic agents to improve neurologic function.","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142209975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Cervical Brace on Postoperative Axial Symptoms Following Single-level Anterior Cervical Discectomy and Fusion","authors":"Qunfei Yu, Ying Ren, Zhan Wang, Guoping Xu, Yaojing Ma, Feifei Ye","doi":"10.1097/bsd.0000000000001696","DOIUrl":"https://doi.org/10.1097/bsd.0000000000001696","url":null,"abstract":"Study Design: Retrospective study. Objective: This study aims to investigate the effect of cervical brace utilization on postoperative axial symptoms in patients undergoing single-segment anterior cervical discectomy and fusion (ACDF). Summary of Background Data: Anterior cervical discectomy and fusion (ACDF) is the most commonly used surgical method in the treatment of cervical spondylosis. For patients with single-segment ACDF. The absence of a neck brace after surgery is safe and does not affect the outcome of surgery. However, the effect on the incidence of AS is unclear. Methods: Patients who underwent anterior cervical single-segment ACDF between May 2020 and August 2021 were retrospectively analyzed. Participants were divided into brace group and nonbraced groups. The incidence of axial symptoms, cervical mobility, and postoperative quality of life were then compared between the 2 groups. Results: A total of 121 patients were included in this study: 62 in the brace group and 59 in the nonbraced group. There were no statistically significant variations observed in the overall demographic characteristics, including age, sex, body mass index, smoking status, and disease duration. The study findings showed that there was a significant decrease in the occurrence of axial symptoms among patients in nonbraced group, in addition to a considerable increase in cervical mobility 1 month following the surgery. Conclusions: The omission of a cervical brace following surgery in patients undergoing single-segment ACDF reduced the incidence of early postoperative axial symptoms, improved their overall quality of life, and facilitated the recovery of postoperative cervical mobility.","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142209976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Serum Albumin and TLC as Predictors of Postoperative Complications in Spine Surgery","authors":"Ayman Mohamed, Connor Sheehan, Paramveer Kaur, Frank Schwab, Alexander Butler","doi":"10.1097/bsd.0000000000001685","DOIUrl":"https://doi.org/10.1097/bsd.0000000000001685","url":null,"abstract":"Study Design: Narrative review. Purpose: To investigate the state of literature regarding serum albumin and total lymphocyte count and their associations with postoperative complications after spine surgery. Methods: Comprehensive search of the PubMed database was performed to find relevant articles addressing preoperative serum albumin, total lymphocyte count, or their respective composite scores and their associations with postoperative complications after spine surgery. Summary of Background Data: Serum albumin level is frequently cited as a marker of patient nutritional status. Total lymphocyte count has more recently gained attention in the literature for similar reasons. Identification of modifiable preoperative patient risk factors for postoperative complications such as malnutrition may help minimize the incidence of postoperative complications. Results: Review of the literature revealed 10 studies that discussed the association between preoperative hypoalbuminemia and postoperative complications. Five studies examined the relationship between either prognostic nutritional index (PNI), controlling nutritional status (CONUT), or both and postoperative complications after spine surgery. Preoperative hypoalbuminemia, low PNI, and high CONUT scores were associated with increased risk of postoperative complications after spine surgery. Conclusions: Preoperative malnourishment is a modifiable patient factor that is associated with an increased risk of postoperative complications after spine surgery.","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142209892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Disc Arthroplasty Device Failure Causing Progressive Cervical Myelopathy and Requiring Revision Cervical Corpectomy.","authors":"Jonathan Parish, Steve H Monk, Matthew O'Brien, Ummey Hani, Domagoj Coric, Christopher M Holland","doi":"10.1097/BSD.0000000000001691","DOIUrl":"https://doi.org/10.1097/BSD.0000000000001691","url":null,"abstract":"<p><strong>Background: </strong>Cervical disc arthroplasty is a well-established alternative to anterior cervical fusion but requires precise placement for optimal outcomes. We present the case of a 2-level cervical disc arthroplasty with suboptimal implantation of the interbody devices, requiring revision corpectomy. Supplemental video, Supplemental Digital Content 1 (http://links.lww.com/CLINSPINE/A358) content of the revision surgery is also provided. This report highlights the importance of proper implant sizing and position and reviews the nuances of surgical revision.</p><p><strong>Methods: </strong>A retrospective review of the clinical and radiographic data was performed from prior to the index operation through the 3-month postoperative period after the surgical revision.</p><p><strong>Results: </strong>The patient presented approximately 2 years post-cervical arthroplasty with increasing neck pain and early cervical myelopathy. An imaging workup revealed severe cervical stenosis at the caudal level with cord compression and concern for device failure. Intraoperatively, the core of the caudal device was found to have ejected into the spinal canal. A cervical corpectomy of the intervening vertebra with the removal of both devices was performed. The patient had a complete neurologic recovery.</p><p><strong>Conclusion: </strong>Although failure of a cervical disc arthroplasty device is rare, the likelihood can be significantly increased with poor sizing (over or under sizing), asymmetric placement, endplate violation, or poor patient selection. In the case presented herein, early device failure was unrecognized, and the patient went on to develop progressive cervical myelopathy requiring revision corpectomy.</p>","PeriodicalId":10457,"journal":{"name":"Clinical Spine Surgery","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}