The insane path of two cervical intervertebral implants: late migration, esophageal ingrowth, and rectal excretion: an exceptional case report.

Abstract

Background: The objective of this report is to present a case of two cervical spine artificial discs (Bryan Cervical Disk) that completely disappeared within 6 months as a result of a high-energy trauma more than 10 years after the initial surgery. Implant dislocation is a known complication in artificial cervical disc replacement. However, this report presents the case of an exceptional migration path with esophageal ingrowth and rectal excretion, not only for one artificial disc but for two at different times It highlights the need for long-term follow-up examinations after artificial cervical disc arthroplasty (ACDA).

Case description: The patient was seen in a Swiss outpatient spine center. He presented with a history of chronic laryngitis, which led to multiple ear, nose, and throat (ENT) diagnostic examinations without any cause being found. Migration of two cervical artificial discs was discovered incidentally in a cervical spine magnet resonance imaging (MRI), which was performed due to chronic myofascial pain in the lower extremities. The MRI showed anterior/retropharyngeal migration of one cervical disc. The second one could not be seen on the whole spine MRI. The complete patient history and radiographic findings were collected and reviewed. In addition, a whole-body computer tomography (CT) scan was done, and the patient was sent to an ENT center to rule out esophagus perforation and to verify the location of the two BRYAN © Cervical Disc.

Conclusions: This case highlights the importance of considering the possibility of migration of an artificial disc in patients who have undergone cervical disc replacement surgery, even if it has been years since the surgery. In particular, patients presenting with symptoms of hoarseness, dysphagia, or globus sensation and a history of cervical disc replacement surgery should receive at least one low-threshold conventional X-ray of the affected segments.