hardware failure ( RID4603 )
There is loosening of the non cemented C4-5 total disc replacement with wide zones of lucency at the metal bone interface of both components that shift between flexion and extension. There is 1.4 mm retrolisthesis of C4 in extension with normalizes in neutral and flexion. Oddly, there was no disc narrowing or dynamic instability 1 year ago, and I dont see much of an HNP in the pre op MRI 1 year ago. Can I differentiate mechanical from infectious loosening from osteolysis in this case? Would you recommend additional imaging? If so, what?

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