Complications in cervical total disc arthroplasty

Short-term and Long-term Complications of Cervical Disk Arthroplasty

“…Nerve root and vascular injury typically become evident immediately or within the initial days postsurgery. Notably, potential complications such as Horner syndrome and recurrent laryngeal nerve injury have been reported in the anterior cervical spine surgery literature 16,23,28 . Two large multicenter retrospective studies each evaluating nearly 9000 patients for incidence of laryngeal nerve injury or Horner syndrome after anterior spine surgery, report an incidence of 0% to 1.25% for laryngeal injury and 0.06% for Horner syndrome 23,28 .…”

“…The short-term complications from CDA are notably influenced by approach-related factors, a characteristic shared with ACDF due to their similar anterior Smith-Robinson approach to the cervical spine. 16,17 These complications encompass a spectrum of challenges, each rooted in the intricacies of surgical techniques, patient physiology, and the anatomic complexities of the anterior cervical region (Table 1).…”

“…Notably, potential complications such as Horner syndrome and recurrent laryngeal nerve injury have been reported in the anterior cervical spine surgery literature. 16,23,28 Two large multicenter retrospective studies each evaluating nearly 9000 patients for incidence of laryngeal nerve injury or Horner syndrome after anterior spine surgery, report an incidence of 0% to 1.25% for laryngeal injury and 0.06% for Horner syndrome. 23,28 Laryngeal nerve injury may lead to symptoms such as hoarseness, dysphonia, or aspiration, while damage to the sympathetic chain that runs anteriorly over the lateral borders of the longus colli muscles can also result in a postoperative Horner syndrome presenting with ptosis, anhidrosis, and miosis.…”

“…31,32 In a meta-analysis by Zavras et al, 31 which included results from a single academic institution with 169 patients as well as 3976 total patients from systematic review reports an incidence of gross device extrusion of 1.2% and 0.3%, respectively. Failure of osseointegration leading to extrusion may also be related to inadequate preparation of the vertebral endplates before Difficulty swallowing 13,18,19 Some studies support the use of IV or local steroids intraoperatively to prevent soft tissue swelling [20][21][22] Laryngeal nerve injury 0-1.25 23 Hoarseness, dysphonia, risk for aspiration 16,23 Careful dissection and retraction of the longus colli muscle [24][25][26][27] Horner syndrome ~0.06 28 Ptosis, anhidrosis, and miosis 28 Careful dissection and retraction of the longus colli muscle 24-27 Hematoma ~0.1 29 May lead to airway compromise or compression of nearby neural structures 29,30 Meticulous hemostasis and caution around vascular structures 29,30 Gross extrusion 0.3 31 Failure of implant osseointegration, risk of device migration and potential esophageal perforation 31,32 Early detection of abnormal postoperative radiographs 33 IV indicates intravenously.…”