title: Transforaminal endoscopic decompression of a postoperative dislocated bone fragment after a 2-level lumbar total disc replacement: case report.
abstract: The proposed advantages of total disc replacement (TDR) over fusion in the lumbar spine are the preservation of motion and the avoidance of adjacent-level disease. One of the complications inherent in TDR is the possibility of vertebral body fracture due to trauma or a malpositioned implant. The resulting dilemma is that posterior decompression of the displaced bone fragment could then have a destabilizing effect and possibly require fusion, thus obviating the benefit of an arthroplasty procedure. In this study, the authors describe the technical considerations and feasibility of the treatment of a postoperative L-5 paresis that resulted from a dislocated bone fragment at L4-5 during a 2-level lumbar TDR.
authors.affiliation: Ligamenta Spine Centre, Frankfurt am Main, Germany;
authors.forename: Ralf
authors.initials: R
authors.lastname: Wagner
authors.affiliation: Spine Clinic Iprenburg, Veenhuizen, The Netherlands; and.
authors.forename: Menno
authors.initials: M
authors.lastname: Iprenburg
authors.affiliation: Department of Neurosurgery, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island.
authors.forename: Albert E
authors.initials: AE
authors.lastname: Telfeian
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D004204:Joint Dislocations / Q000209:etiology* / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000601:surgery; D011183:Postoperative Complications / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D059145:Total Disc Replacement / Q000009:adverse effects*
keywords: TDR = total disc replacement; endoscopic discectomy; minimally invasive; total disc replacement; transforaminal