title: Complications related to hydroxyapatite vertebral spacer in anterior cervical spine surgery.
abstract: METHODS
  This is a report of complications related to the hydroxyapatite vertebral spacer used for anterior cervical reconstructive surgery. Compression of the spinal cord by broken fragments of hydroxyapatite spacer as well as its surrounding radiolucent clear zone were observed in seven patients.
  
  
  OBJECTIVE
  To report complications related to the use of hydroxyapatite vertebral spacer for anterior cervical reconstructive surgery and to discuss how to prevent these complications.
  
  
  BACKGROUND
  Despite previous articles reporting the clinical applications of hydroxyapatite vertebral spacer for the cervical spine, clinical reports regarding the long-term results of hydroxyapatite spacer for anterior cervical surgery and its complications have been limited.
  
  
  METHODS
  The authors reviewed patients who underwent anterior reconstructive surgery using the hydroxyapatite spacer at other hospitals and had postoperative complications related to hydroxyapatite spacer.
  
  
  RESULTS
  Seven patients previously treated by anterior cervical spine surgery using the hydroxyapatite vertebral spacer were referred to the authors because of unsatisfactory surgical outcomes. All the patients had a radiolucent clear zone around the spacer and experienced severe neck pain. Four had fracture of the hydroxyapatite spacer, and two had compression of the spinal cord by retropulsed fragments of broken hydroxyapatite spacers.
  
  
  CONCLUSIONS
  Although hydroxyapatite has been used in many medical fields because of its bioactive characteristics, its mechanical properties should be improved to lessen the risks of breakage and subsequent spinal cord compression. Gentle insertion maneuvers are also important to avoid the production of cracks inside the spacer.
authors.affiliation: Bibai Rosai Hospital.
authors.forename: Manabu
authors.initials: M
authors.lastname: Ito
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Abumi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Shono
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Kotani
authors.forename: Akio
authors.initials: A
authors.lastname: Minami
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Kaneda
mesh_terms: D000368:Aged; D019299:Decompression, Surgical / Q000009:adverse effects; D017886:Durapatite / Q000009:adverse effects*; D004935:Esophageal Diseases / Q000175:diagnosis / Q000209:etiology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009333:Neck; D019547:Neck Pain / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000209:etiology; D019736:Prostheses and Implants / Q000009:adverse effects*; D011475:Prosthesis Failure; D012086:Reoperation; D013117:Spinal Cord Compression / Q000209:etiology / Q000601:surgery; D013122:Spinal Diseases / Q000601:surgery*; D013123:Spinal Fusion / Q000009:adverse effects* / Q000379:methods; D014057:Tomography, X-Ray Computed
chemical_list: D017886:Durapatite