Osteolysis after cervical disc arthroplasty
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REVIEW ARTICLE
Osteolysis after cervical disc arthroplasty Andrei Fernandes Joaquim1 · Nathan J. Lee2 · Ronald A. Lehman Jr.2 · Luis M. Tumialán3 · K. Daniel Riew2 Received: 30 May 2020 / Revised: 9 July 2020 / Accepted: 20 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Cervical disc arthroplasty (CDA) has become an increasingly popular treatment for cervical degenerative disc disease. One potential complication is osteolysis. However, current literature on this topic appears limited. The purpose of this study is to elucidate the incidence, aetiology, consequence, and subsequent treatment of this complication. Methods A systematic literature review was performed according to the PRISMA guidelines. Studies discussing the causes, incidence and management of osteolysis after a CA were included. Results A total of nine studies were included. We divided these studies into two groups: (1) large case series in which an active radiological evaluation for osteolysis was performed (total = six studies), (2) case report studies, which discussed symptomatic cases of osteolysis (total = three). The incidence of asymptomatic osteolysis ranged from 8 to 64%; however, only one study reported an incidence of 0.05) Mobi-C had significantly more anterior bone loss (p = 0.001) No patients required a reoperation for anterior bone loss during the course of the study No cases of progressive anterior bone loss beyond the first year Anterior bone loss occurred in 57.1% (45.5% mild, 8.3% moderate and 3.2% severe) and started 3 months followed by the operation They did not report a relationship between anterior bone loss degree and pain/functional outcome Mild and moderate anterior bone loss affects more the upper endplate (56.8% and 57.9%) but severe anterior bone loss generally occurred at the inferior endplate (66.7%)
Conclusions
Table 1 Summary of the studies with large patient populations and radiological investigation of osteolysis at the index level
European Spine Journal
121 patients who had a 1-level Bryan CDA Anterior bone loss was graded as: grade 0—no remodelling; grade 1—spur disappearance or mild change in body contour; 2—obvious bone regression with Bryan disc exposure Shell angle—determined by measuring the angle between the upper and lower inner surface of the Bryan artificial disc Radiological assessment was performed at many time points, with at least 24 months of follow-up Chen et al. [8] Retrospective case series
Anterior bone loss was found in 53 (43.8%) of the upper adjacent level and 54 (44.6%) in the lower adjacent level 29 patients (23.9%) had anterior bone loss in both levels Grade 1–44 patients (36.3%) Grade 2–5 patients (4%) in the upper level and 4 patients (3.3%) in the lower level No correlation with global alignment, global or index Range of motion (ROM) Shell angle was different in Grade O (5°) versus Grade 1–2 group (7°)—p 0.05). In comparison to other implants, the Mobi-C implant had significantly more anterior bone loss (p = 0.001). Finally, no p
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