Unexplained perioperative vertebrobasilar stroke in a patient undergoing anterior cervical decompression and disc arthroplasty.

Background: Vertebrobasilar stroke associated with the anterior approach to the cervical spine is rare and has not been reported in cervical disc arthroplasty surgery. We report the case of a 60-year-old patient who underwent cervical disc arthroplasty at C4-5, C5-6 and C6-7. Postoperatively, due to symptoms and signs of a cerebellar stroke, magnetic resonance imaging of the brain was obtained confirming this diagnosis.

Lumbar total disc arthroplasty: coronal midline definition and optimal TDA placement.

It is a general principle with arthroplasty insertion that precise implant centering is critical for long term function and outcome. Whilst some authors have proclaimed that lumbar total disc arthroplasty (TDA) may be different, and that off -centre placement may be functionally well tolerated, these claims are premature: significantly worse clinical results have already been reported with poorly placed TDA at 2 years. Accurate TDA placement requires a precise and consistent definition of the desired coronal midline target (which is currently lacking), as well as a procedural mechanism to optimize placement at that target.

Significantly improved lumbar arthroplasty placement using image guidance: technical note.

Study Design: Technical report.

Objective: To compare the accuracy of lumbar total disc arthroplasty placement using an image-guidance system (IGS) with conventional fluoroscopy.

Summary Of Background Data: Most disc arthroplasties are inserted and analyzed using fluoroscopy.