title: Delayed hypersensitivity reaction after cervical disc replacement: a case report.
abstract: We report a case of allergic reaction after total cervical disc arthroplasty. A 52-year old woman was operated on for right C6 cervicobrachial neuralgia secondary to C5-C6 disc disease with foraminal stenosis. A cobalt-chromium-molybdenum total disc prosthesis had been implanted two years earlier. The patient was referred to our institution for recurrence of axial neck pain associated with abdominal patches of erythematous itching rash and swallowing disorder. Allergy tests confirmed type-4 allergic reaction to chromium. Symptoms decreased after removal of the prosthesis with secondary fusion. Delayed allergic reaction is uncommon in spine surgery, but should be considered in case of recurrence of initial symptomatology associated with non-spinal signs.
authors.affiliation: Unité de chirurgie du Rachis, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Lagier
authors.affiliation: Unité de chirurgie du Rachis, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: M
authors.initials: M
authors.lastname: Briere
authors.affiliation: Unité de chirurgie du Rachis, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: H
authors.initials: H
authors.lastname: Giorgi
authors.affiliation: Unité de chirurgie du Rachis, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: S
authors.initials: S
authors.lastname: Fuentes
authors.affiliation: Unité de chirurgie du Rachis, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France. Electronic address: benjamin.blondel@ap-hm.fr.
authors.forename: B
authors.initials: B
authors.lastname: Blondel
authors.affiliation: Unité de chirurgie du Rachis, CHU Timone, 264, rue Saint-Pierre, 13385 Marseille cedex 5, France.
authors.forename: P
authors.initials: P
authors.lastname: Tropiano
mesh_terms: D002574:Cervical Vertebrae / Q000601:surgery; D003680:Deglutition Disorders / Q000209:etiology; D004890:Erythema / Q000209:etiology; D005260:Female; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000175:diagnosis / Q000209:etiology*; D007403:Intervertebral Disc / Q000601:surgery; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology; D019736:Prostheses and Implants / Q000009:adverse effects*; D059145:Total Disc Replacement / Q000295:instrumentation*
keywords: Allergy; Delayed hypersensitivity; Rash; Total disc arthroplasty