Cervical instability following artificial disc replacement

BACKGROUND: Although there has been increased interest in utilizing artificial disc replacement (ADR) techniques to treat cervical degenerative disease, few reports have focused on their postoperative complication and reoperation rates. CASE DESCRIPTION: A 52-year-old male underwent the uneventful placement of a C5-C6 cervical ADR for disc disease and foraminal stenosis. One year later, he experienced the onset of severe neck pain attributed to instability of the ADR construct. This required removal of the C5-6 ADR and subsequent fusion. CONCLUSION: Strict adherence to appropriate criteria is critical for choosing when to place a cervical ADR. This requires documenting; adequate surgical indications, careful selection of the appropriate ADR device, meticulous surgical technique, proper preservation of the supporting structures, and sufficient neural decompression.