{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T19:45:04Z","timestamp":1769802304855,"version":"3.49.0"},"reference-count":6,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Viscoelastic lumbar total disc replacements (TDRs) can develop periprosthetic osteolysis likely attributable to wear debris and micromotion at the core\u2013endplate interface. Early recognition and revision are essential to avoid prosthesis explantation. Here, we present two patients with cystic osteolysis following Elastic Spine Pad - Lumbar (ESP-L) viscoelastic lumbar disc arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Two patients developed symptomatic cystic osteolysis within 5 years of ESP-L implantation documented utilizing multimodal imaging (i.e., radiographs and computed tomography). Revision surgery in two cases was based on cyst morphology and implant stability. Case 1 had a large posterior osteolytic cavity and underwent posterior cortical bone trajectory (CBT) fusion with autologous bone grafting. Case 2, with a contained lesion adjacent to an otherwise stable implant, was treated with targeted percutaneous cement augmentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Longitudinal imaging and clinical follow-up showed symptomatic improvement and radiologic stabilization in both patients. In Case 1, the osteolytic cavity fully resolved within 18 postoperative months, whereas Case 2 achieved immediate mechanical reinforcement and sustained pain reduction following cement injection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Cystic osteolysis is a potential complication of viscoelastic lumbar TDRs. These cases demonstrated that posterior CBT fusion or percutaneous cement augmentation could provide effective symptomatic relief and radiologic stabilization, avoiding the need to remove the prosthesis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_1307_2025","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:21:30Z","timestamp":1769761290000},"page":"57","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Revision strategies following ESP-L lumbar disc arthroplasty complicated by osteolysis and recurrent symptoms"],"prefix":"10.25259","volume":"17","author":[{"given":"Ralph Jasper","family":"Mobbs","sequence":"first","affiliation":[{"name":"Faculty of Medicine, University of New South Wales, Sydney, Australia"},{"name":"NeuroSpine Surgery Research Group, Randwick, New South Wales, Australia"},{"name":"NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chris","family":"Huang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of New South Wales, Sydney, Australia"},{"name":"NeuroSpine Surgery Research Group, Randwick, New South Wales, Australia"},{"name":"NeuroSpine Clinic, Prince of Wales Private Hospital, Randwick, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Ma","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of New South Wales, Sydney, Australia"},{"name":"NeuroSpine Surgery Research Group, Randwick, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2026,1,30]]},"reference":[{"key":"10.25259\/SNI_1307_2025\/ref-1","doi-asserted-by":"crossref","first-page":"2230","DOI":"10.2106\/JBJS.G.01712","article-title":"Chronic failure of a lumbar total disc replacement with osteolysis. Report of a case with nineteen-year follow-up","volume":"90","author":"Devin","year":"2008","journal-title":"J Bone Joint Surg Am"},{"key":"10.25259\/SNI_1307_2025\/ref-2","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1111\/os.12027","article-title":"\u201cMedio-latero-superior trajectory technique\u201d: An alternative cortical trajectory for pedicle fixation","volume":"5","author":"Mobbs RJ","year":"2013","journal-title":"Orthop Surg"},{"key":"10.25259\/SNI_1307_2025\/ref-3","doi-asserted-by":"crossref","first-page":"228","DOI":"10.21037\/jss.2017.04.01","article-title":"Intraoperative navigation for accurate midline placement of anterior lumbar interbody fusion and total disc replacement prosthesis","volume":"3","author":"Phan","year":"2017","journal-title":"J Spine Surg"},{"key":"10.25259\/SNI_1307_2025\/ref-4","doi-asserted-by":"crossref","first-page":"e321","DOI":"10.1016\/j.wneu.2019.11.158","article-title":"Three-dimensional morphometric analysis of lumbar vertebral end plate anatomy","volume":"135","author":"Singh","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1307_2025\/ref-5","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1097\/01.brs.0000251370.56327.c6","article-title":"Polyethylene wear debris and long-term clinical failure of the Charit\u00e9 disc prosthesis: A study of 4 patients","volume":"32","author":"Van Ooij","year":"2007","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI_1307_2025\/ref-6","doi-asserted-by":"crossref","first-page":"S494","DOI":"10.1007\/s00586-014-3535-0","article-title":"Rare complications of osteolysis and periprosthetic tissue reactions after hybrid and non-hybrid total disc replacement","volume":"24","author":"Veruva","year":"2015","journal-title":"Eur Spine J"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/revision-strategies-following-esp-l-lumbar-disc-arthroplasty-complicated-by-osteolysis-and-recurrent-symptoms\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/revision-strategies-following-esp-l-lumbar-disc-arthroplasty-complicated-by-osteolysis-and-recurrent-symptoms\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T08:21:31Z","timestamp":1769761291000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/revision-strategies-following-esp-l-lumbar-disc-arthroplasty-complicated-by-osteolysis-and-recurrent-symptoms\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,30]]},"references-count":6,"alternative-id":["10.25259\/SNI_1307_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_1307_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,1,30]]},"article-number":"57"}}