Acta Neurochirurgica

, Volume 155, Issue 2, pp 321–322 | Cite as

Foreign body reaction to hydroxyapatite after anterior cervical discectomy with fusion

  • José Pedro LavradorEmail author
  • Sérgio Livraghi
  • Pedro Pereira
  • José Pimentel
Letter to the editor - Spine

Dear Editor,

The surgical management of cervical disc herniation has greatly evolved over the last century. Shortly after the anterior cervical approach and fusion with a horseshoe bone graft [5], the interbody fusion using autologous iliac bone was described [2], and recent studies have highlighted the morbidity associated with these autografts [3, 8, 9], mainly donor site morbidity and limited supply. Consequently, the use of allograft or synthetic materials for fusion has been increasing. Nevertheless, the fusion rates are similar for the three methods, with synthetic materials averting the pain of autograft bone sourcing and being less expensive than allograft bone use [1, 7]. We are reporting an unexpected complication following the use of phosphocalcic hydroxylapatite after anterior cervical discectomy with fusion.

A 68-year-old man with type 2 diabetes mellitus, came to the out–patient clinic of our department complaining of decreased strength on the right limbs. He presented...


Hydroxyapatite Foreign Body Reaction Cervical Disc Hydroxylapatite Anterior Cervical Discectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors are grateful to Prof. Doutor João Lobo Antunes for the proofread and the critical analysis of this article.

Conflicts of interest



  1. 1.
    Bruneau M, Nisolle JF, Gilliard C, Gustin T (2001) Anterior cervical interbody fusion with hydroxyapatite graft and plate system. Neurosurg Focus 10(4):E8PubMedCrossRefGoogle Scholar
  2. 2.
    Cloward RB (1958) The anterior approach for removal of ruptured cervical disks. Neurosurgery 15:602–617CrossRefGoogle Scholar
  3. 3.
    Delawi D, Dhert WJ, Castelein RM, Verbout AJ, Oner FC (2007) The incidence of donor site pain after bone graft harvesting from the posterior iliac crest may be overestimated: a study on spine fracture patients. Spine 32:1865–1868PubMedCrossRefGoogle Scholar
  4. 4.
    Kuraishi K, Hanakita J, Takahashi T, Minami M, Mori M, Watanabe M (2011) Remarkable epidural scar formation compressing the cervical cord after osteoplastic laminoplasty with hydroxyapatite spacer. J Neurosurg Spine 15:497–501PubMedCrossRefGoogle Scholar
  5. 5.
    Robinson RA, Smith GW (1995) Anterolateral cervical disc removal and interbody fusion for cervical disc syndrome. Bull Johns Hopkins Hosp 96:223–224Google Scholar
  6. 6.
    Rosner M, Edward DP, Tso MO (1992) Foreign-body giant-cell reaction to hydroxyapatite orbital implant. Arch Opthalmol 110:173–174CrossRefGoogle Scholar
  7. 7.
    Samartzis D, Shen FH, Matthews DK, Yoon ST, Goldberg EJ, An HS (2003) Comparison of allograft to autograft in multilevel anterior cervical discectomy and fusion with rigid plate fixation. Spine J 3:451–459PubMedCrossRefGoogle Scholar
  8. 8.
    Sasso RC, LeHuec JC, Shaffrey C (2005) Iliac crest bone graft donor site pain after anterior lumbar interbody fusion: a prospective patient satisfaction outcome assessment. J Spinal Disord Tech 18(suppl):S77–S81PubMedCrossRefGoogle Scholar
  9. 9.
    Silber JS, Anderson DG, Daffner SD, Brislin BT, Leland JM, Hilibrand AS, Vaccaro AR, Albert TJ (2003) Donor site morbidity after anterior iliac crest bone harvest for single-level anterior cervical discectomy and fusion. Spine 28:134–139PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2012

Authors and Affiliations

  • José Pedro Lavrador
    • 1
    • 3
    Email author
  • Sérgio Livraghi
    • 1
  • Pedro Pereira
    • 2
  • José Pimentel
    • 2
  1. 1.Department of NeurosurgeryHospital de Santa Maria, CHLNLisbonPortugal
  2. 2.Laboratory of NeuropathologyHospital Santa Maria, CHLNLisbonPortugal
  3. 3.Mem-MartinsPortugal

Personalised recommendations