Note: in the full-text, it states that the patient injured her spine eight weeks after being discharged and was diagnosed with cauda equina syndrome in which she was taken back to the operating room for another revision surgery (the patient had two revisions).
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Spine. Volume 35(24), 15 November 2010, pp E1430-E1434

Revision Strategy for Posterior Extrusion of the CHARITÉ Polyethylene Core

Eskander, Mark S. MD*; Onyedika, Ikechukwu I. MD†; Eskander, Jonathan P. AB*; Connolly, Patrick J. MD*; Eck, Jason C. DO, MS*; Lapinsky, Anthony MD*. Author Information: From the Departments of *Orthopedics and †Surgery, UMASS Memorial Medical Center, Worcester, MA. © 2010 Lippincott Williams & Wilkins, Inc.

Study Design. This is a case report of a posterior extrusion of the polyethylene core from a CHARITÉ arthroplasty. This is the first reported case of posterior dislocation of the polyethylene and the revision strategies used to correct this problem.

Objective. To report a novel failure mechanism and revision strategy for CHARITÉ total disc arthroplasty (TDA).

Summary of Background Data. Case report at a Level 1 tertiary care referral center in the northeastern United States.

Methods. This is a case report and review of the literature of a patient who sustained posterior dislocation of the polyethylene core from a CHARITÉ TDA several months after the index procedure.

Results. Core dislocation is a known complication of TDA. However, of the known reported dislocations all have been anterior. This case describes the first known occurrence of posterior core dislocation and the revision strategy for this problem.

Conclusion. This case report highlights the first known case of a posterior dislocation of a CHARITÉ core. It is likely that altered biomechanical forces generated over time attributed to device failure. An instrumented posterior fusion with removal of the core is what ultimately led to a stable revision construct.