Granulomatous Reaction on a Double-Level Cervical Total Disc Arthroplasty.


Journal

World neurosurgery
ISSN: 1878-8769
Titre abrégé: World Neurosurg
Pays: United States
ID NLM: 101528275

Informations de publication

Date de publication:
Feb 2019
Historique:
received: 07 07 2018
revised: 06 11 2018
accepted: 08 11 2018
pubmed: 21 11 2018
medline: 8 3 2019
entrez: 21 11 2018
Statut: ppublish

Résumé

Cervical total disc arthroplasty (TDA), or cervical artificial disc replacement, is an alternative technique to anterior cervical discectomy and fusion for treatment of symptomatic degenerative cervical spine disease. The main goal of TDA is to maintain cervical motion and lower the risk of deterioration of adjacent levels. Granuloma formation on a cervical TDA is exceptional. A 48-year-old woman with left cervicobrachialgia underwent a double-level TDA (M6-C Artificial Cervical Disc) on C5-C6 and C6-C7 at another hospital in 2010. Two years later, she reported a recurrence of cervicalgia, which was refractory to conservative treatment by rigid collar and analgesics. Cervical magnetic resonance imaging suggested a granulomatous formation on the C6-C7 prosthesis. She underwent removal of the C6-C7 prosthesis, which showed a rupture with nylon thread extrusion. An arthrodesis with plate was subsequently performed. Follow-up showed improvement of her clinical status. Histopathologic studies showed a giant cell granulomatous formation in contact with nylon threads described in hip, shoulder, and ankle arthroplasty. It has been described in 6 cases following lumbar TDA and 2 cases following cervical TDA. We report a third case of granulomatous reaction on nylon thread extrusion after partial breakdown of a prosthesis for cervical TDA.

Sections du résumé

BACKGROUND BACKGROUND
Cervical total disc arthroplasty (TDA), or cervical artificial disc replacement, is an alternative technique to anterior cervical discectomy and fusion for treatment of symptomatic degenerative cervical spine disease. The main goal of TDA is to maintain cervical motion and lower the risk of deterioration of adjacent levels. Granuloma formation on a cervical TDA is exceptional.
CASE DESCRIPTION METHODS
A 48-year-old woman with left cervicobrachialgia underwent a double-level TDA (M6-C Artificial Cervical Disc) on C5-C6 and C6-C7 at another hospital in 2010. Two years later, she reported a recurrence of cervicalgia, which was refractory to conservative treatment by rigid collar and analgesics. Cervical magnetic resonance imaging suggested a granulomatous formation on the C6-C7 prosthesis. She underwent removal of the C6-C7 prosthesis, which showed a rupture with nylon thread extrusion. An arthrodesis with plate was subsequently performed. Follow-up showed improvement of her clinical status. Histopathologic studies showed a giant cell granulomatous formation in contact with nylon threads described in hip, shoulder, and ankle arthroplasty. It has been described in 6 cases following lumbar TDA and 2 cases following cervical TDA.
CONCLUSIONS CONCLUSIONS
We report a third case of granulomatous reaction on nylon thread extrusion after partial breakdown of a prosthesis for cervical TDA.

Identifiants

pubmed: 30458326
pii: S1878-8750(18)32617-2
doi: 10.1016/j.wneu.2018.11.070
pii:
doi:

Substances chimiques

Nylons 0

Types de publication

Case Reports Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

360-363

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Cedric Baltus (C)

Department of Neurosurgery, Saint-Luc Hospital, Université Catholique de Louvain, Brussels, Belgium.

Emmanuel Costa (E)

Department of Neurosurgery, Saint-Luc Hospital, Université Catholique de Louvain, Brussels, Belgium.

Geraldo Vaz (G)

Department of Neurosurgery, Saint-Luc Hospital, Université Catholique de Louvain, Brussels, Belgium.

Christian Raftopoulos (C)

Department of Neurosurgery, Saint-Luc Hospital, Université Catholique de Louvain, Brussels, Belgium. Electronic address: christian.raftopoulos@uclouvain.be.

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