Postoperative segmental hypermobility after cervical arthroplasty: A possible pathomechanism for outcome failure

Oliver P Gautschi; Marco V Corniola; Martin N Stienen; Nicolas R Smoll; Dieter Cadosch

doi:10.1016/j.jocn.2014.12.025

Postoperative segmental hypermobility after cervical arthroplasty: A possible pathomechanism for outcome failure

J Clin Neurosci. 2015 Jul;22(7):1194-6. doi: 10.1016/j.jocn.2014.12.025. Epub 2015 Apr 7.

Authors

Oliver P Gautschi¹, Marco V Corniola², Martin N Stienen², Nicolas R Smoll³, Dieter Cadosch⁴

Affiliations

¹ Department of Neurosurgery and Faculty of Medicine, University Hospital, Rue Gabrielle-Perret-Gentil 4, Geneva 1211, Switzerland. Electronic address: oliver.gautschi@hcuge.ch.
² Department of Neurosurgery and Faculty of Medicine, University Hospital, Rue Gabrielle-Perret-Gentil 4, Geneva 1211, Switzerland.
³ Department of Medicine, Frankston Hospital, Frankston, Melbourne, VIC, Australia.
⁴ Trauma Unit, John Radcliffe Hospital, University of Oxford, Oxford, UK.

PMID: 25861889
DOI: 10.1016/j.jocn.2014.12.025

Abstract

We present a 41-year-old man who underwent a cervical discarthroplasty (CDA) C5-6 procedure with an increase of the segmental range of motion from 2.8° to 6.9° and an increase in disc height from 5.8mm preoperatively to 10.4mm postoperatively with an unfavorable long-term clinical outcome. Both anterior cervical discectomy with fusion (ACDF), as well as CDA have been proven to be successful procedures in the management of cervical radiculopathy with good to excellent outcomes and low complication rates. The rationale for CDA over ACDF highlights the preservation of segmental motion and reduction of the incidence of adjacent segment disease. This case report suggests that a hypermobility syndrome and also an overcorrection of the cervical range of motion may be responsible for an unfavorable outcome after CDA.

Keywords: Cervical arthroplasty; Functional segmental unit; Overcorrection; Postoperative segmental hypermobility; Range of motion.

Publication types

Case Reports

MeSH terms

Adult
Arthroplasty / adverse effects*
Cervical Vertebrae / surgery*
Humans
Intervertebral Disc / surgery
Intervertebral Disc Degeneration / surgery
Joint Instability / etiology*
Joint Instability / physiopathology
Magnetic Resonance Imaging
Male
Neck Pain / etiology
Postoperative Complications / physiopathology*
Range of Motion, Articular
Spinal Fusion / adverse effects
Treatment Failure