An Atypical Presentation of Early Periprosthetic Infection After Cervical Disc Arthroplasty
Case: A 22-year-old woman with Klippel-Feil syndrome who underwent cervical disc arthroplasty (CDA) presented 3 months postoperatively with worsening neck pain and radiculopathy. Work-up was negative for infection, but single- photon emission computed tomography revealed increased metabolic activity in the vertebral body below the implant. During revision, the implant was grossly loose and multiple cultures grew Cutibacterium acnes. She was treated with an antibiotic course and conversion to anterior fusion without recurrence.
Conclusion: This report highlights the rare presentation of an early periprosthetic infection after CDA caused by C.acnes.
Preoperative cervical spine radiographs. Anterior-posterior view (Fig. 1-A) demonstrating mild rotary dextroscoliosis of the lower cervical spine presumably related to left-sided partial fusion of C6-C7 (arrow). Lateral view (Fig. 1-B) showing reversal of cervical lordosis with apex at C5 and wasp-waist sign at C6-C7 (arrow). Extension (Fig. 1-C) and flexion (Fig. 1-D) views demonstrate mild 2 mm anterolisthesis of C2-C3, C3-C4, and C4-C5 without dynamic instability.