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Spontaneous Fusion After Cervical Disc Arthroplasty: A Case Report and Literature Review

Authors Ge CY, Wang J, Zhang BF, Hui H, Shan LQ, Zhao QP, Hao DJ

Received 17 December 2019

Accepted for publication 3 April 2020

Published 21 April 2020 Volume 2020:13 Pages 771—776


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr E Alfonso Romero-Sandoval

Chao-Yuan Ge,1,* Jing Wang,2,* Bin-Fei Zhang,3,* Hao Hui,1 Le-Qun Shan,1 Qin-Peng Zhao,1 Ding-Jun Hao1

1Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, Shaanxi Province, People’s Republic of China; 2Department of Ophthalmology, Xi’an Fourth Hospital, Xi’an 710004, Shaanxi Province, People’s Republic of China; 3Department of Trauma Orthopedics, Honghui Hospital, Xi’an Jiaotong University, Xi’an 710054, Shaanxi Province, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Qin-Peng Zhao; Ding-Jun Hao
Department of Spine Surgery, Honghui Hospital, Xi’an Jiaotong University, No. 555 Friendship East Road, Beilin District, Xi’an 710054, Shaanxi Province, People’s Republic of China
Tel/ Fax +86-29-62818374
; +86-29-87894724

Objective: To report a rare case of spontaneous fusion (SF) following cervical disc arthroplasty (CDA), to review the related literature, and to propose a new measure to prevent it.
Methods: The course of a patient with SF is described here. The potential causes, risk factors, and preventive measure of SF after CDA published in previous studies have also been reviewed and discussed.
Results: A 63-year-old man presented with a 6-month history of progressive neck pain and developed left C-7 radiculopathy 4 years ago. Magnetic resonance imaging revealed disc herniation at the C6–C7 levels resulting in compression of the left C-7 nerve root. The patient underwent CDA at the C6–C7 levels, during which a PRESTIGE cervical disc device was implanted. He failed to follow-up regularly as recommended postoperatively because he was completely free from the pain in his neck and left upper limb. Four years later, he was readmitted with a 2-month history of occasional neck stiffness. Plain radiographs indicated complete radiographic fusion of the C6–C7 levels with trabecular bone bridging surrounding the cervical disc prosthesis, and dynamic imaging showed no motion. He was seen at regular follow-up visits for up to 60 months without special treatment, as his symptoms of neck stiffness were minor and his symptom has not worsened since then.
Conclusion: SF after CDA is a rare condition that can be attributed to patient- or prosthesis-related causes, and its risk factors are diverse. SF after CDA did not affect the patient’s clinical outcome, and no special treatment was required for it. Practitioners should be aware of this rare complication and advise patients of the risks before performing CDA.

Keywords: adjacent segment disease, cervical disc arthroplasty, spontaneous fusion, heterotopic ossification

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