Rare complications of osteolysis and periprosthetic tissue reactions after hybrid and non-hybrid total disc replacement.
Rare complications of osteolysis and periprosthetic tissue reactions after hybrid and non-hybrid total disc replacement.
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混合和非混合全椎间盘置换术后骨质溶解和假体周围组织反应的罕见并发症。
DOI：
10.1007/s00586-014-3535-0
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Steinbeck,MarlaJ
中科院分区：
文献类型：
--
作者：
Veruva,SaiY;Lanman,ToddH;Hanzlik,JosaA;Kurtz,StevenM;Steinbeck,MarlaJ
目的腰椎全椎间盘置换术（TDR）和混合TDR固定术的并发症很少。本研究评估了两例ProDisc-L假体椎间盘置换术后骨质溶解的取出植入物和假体周围组织反应。（偏振光显微镜）和金属碎片结果尽管最初的手术结果良好，在两名患者中，在邻近植入物的椎骨处观察到溶骨性囊肿。对于混合型TDR病例，观察到由于磨损引起的炎症导致的异位骨化和组织坏死。相比之下，非混合种植体表现出磨损和冲击的迹象，并观察到炎症与金属和聚乙烯磨损debrids.ConclusionsIn这两种情况下，磨损碎屑和炎症的组织区域可能导致骨质溶解。使用ProDisc假体的外科医生应注意这些罕见的并发症。
PurposeFew complications have been reported for lumbar total disc replacement (TDR) and hybrid TDR fixations. This study evaluated retrieved implants and periprosthetic tissue reactions for two cases of osteolysis following disc arthroplasty with ProDisc-L prostheses.MethodsImplants were examined for wear and surface damage, and tissues for inflammation, polyethylene wear debris (polarized light microscopy) and metal debris (energy-dispersive X-ray spectroscopy).ResultsDespite initial good surgical outcomes, osteolytic cysts were noted in both patients at vertebrae adjacent to the implants. For the hybrid TDR case, heterotopic ossification and tissue necrosis due to wear-induced inflammation were observed. In contrast, the non-hybrid implant showed signs of abrasion and impingement, and inflammation was observed in tissue regions with metal and polyethylene wear debris.ConclusionsIn both cases, wear debris and inflammation may have contributed to osteolysis. Surgeons using ProDisc prostheses should be aware of these rare complications.