Cuidados técnicos durante la artroplastia cervical: presentación de dos casos / Technical pitfalls during cervical arthoplasty: Report of two cases

ABSTRACT

Objective: to describe and analyze two cases of cervical arthroplasty with spinal misalignment. Description Both, a 44 year old female (case 1) with a 9 months history of myeloradiculopathy and a 50 year old female (case 2) with a 2 year history of cervicobrachial pain had a C5-C6 posterolateral discal hernia diagnosed by magnetic resonance. As medical treatment failed, both patients were taken to surgery. Intervention In both cases we performed a cervical arthroplasty using a 14mm Bryan cervical disc prosthesis. There were no intraoperative complications. Case 1 had a postoperative sagittal misalignment and plate angle was -10° (preoperative +3°). This was caused by an inappropriate use of the manual stabilizer. Case 2 had a postoperative coronal misalignment coronal angle was 18° (preoperative 0°). This was caused by the asymmetric anterior ostheophyte and end plate drilling. At the latest follow-up, 6 and 3 months respectively, case 1 still had muscular pain and case 2 was asymptomatic. Conclusion: In both cases misalignment problems could have been avoided with a proper surgical technique and were not inherent to the insertion technique.