Asymptomatic Anterior Extrusion of Total Disc Replacement in the Hypopharynx: A Case Report on Revision with Hybrid Construct

Introduction Cervical total disc replacement (TDR) offers the benefit of motion preservation and reduced adjacent segment degeneration compared to anterior cervical discectomy and fusion (ACDF). TDR is indicated for single- or two-level cervical degenerative disc disease with radiculopathy or myelopathy in otherwise healthy individuals. While mid- and long-term outcomes are generally favorable, delayed hardware complications, though infrequent, can have serious consequences. Anterior extrusion of cervical TDR components is a documented but uncommon complication. Such failures may be attributed to poor bone integration, undersizing or malpositioning of implants, or underlying biomechanical factors. In symptomatic patients, revision strategies typically include conversion to ACDF, which remains the standard approach. Typical ACDF indications aside from TDR conversion salvage include degenerative disc disease, spinal fractures from trauma, infection and tumors. Surgical Indications are dependent on the type of deformity, neurological compromise, and spinal instability.” 2 TDR failure presenting without symptoms poses a diagnostic challenge and can delay intervention. This report presents an unusual case of asymptomatic anterior TDR extrusion into the hypopharynx, discovered incidentally, with revision managed through a hybrid construct combining retained TDR and ACDF.