Vertebral body split fracture after a single-level cervical total disc replacement

Case report

Tsung-Hsi TuDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital; and
School of Medicine and

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Jau-Ching WuDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital; and
School of Medicine and
Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan

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Li-Yu FayDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital; and
School of Medicine and

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Chin-Chu KoDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital; and
School of Medicine and

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Wen-Cheng HuangDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital; and
School of Medicine and

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Henrich ChengDepartment of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital; and
School of Medicine and
Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan

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Cervical total disc replacement (TDR) is a viable option for the surgical treatment of degenerative disc disease. This 67-year-old nonsmoking male patient underwent single-level ProDisc-C cervical TDR at C5–6 without any intraoperative problem. His radicular pain improved and he had no neck pain immediately after the operation. However, on postoperative Day 3, a radiograph demonstrated a vertical split fracture of the C-5 vertebra. This fracture was managed conservatively, and 2 years postoperatively a follow-up CT scan demonstrated stable device position and fusion of the fracture. Although the linear fracture caused no neurological symptoms or device migration, the authors advocate prudence in selection and installation of keel-design prostheses, even in a single-level cervical TDR scenario.

Abbreviations used in this paper:

ACDF = anterior cervical discectomy and fusion; TDR = total disc replacement.
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    Tu TH, , Wu JC, , Huang WC, , Guo WY, , Wu CL, & Shih YH, et al.: Heterotopic ossification after cervical total disc replacement: determination by CT and effects on clinical outcomes. Clinical article. J Neurosurg Spine 14:457465, 2011

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