Influence of Fusion on the Behavior of Adjacent Disc Arthroplasty in Contiguous 2-Level Hybrid Surgery In Vivo

Hu, Lidan; Wu, Tingkui; Líu, Hao; Wang, Beiyu; Zhang, Jianying; Meng, Yang; Ding, Chen; Gao, Xinlin; Hong, Ying

doi:10.1016/j.wneu.2019.07.073

Cited by 10 publications

(9 citation statements)

References 31 publications

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“…However, different prostheses have their distinct biomechanical characteristics, design, and implantation techniques which have been postulated to contribute to the formation of HO [26,27]. And the HO incidence rate of Prestige-LP has been reported to range from 31.3 to 41.9% [13,19,20], compared with 66.0% (64/97) in the current study. The behavior of the arthroplasty level adjacent to fusion in HS could be more severely affected than that in stand-alone CDA [5,28].…”

Section: Discussionmentioning

confidence: 51%

“…The behavior of the arthroplasty level adjacent to fusion in HS could be more severely affected than that in stand-alone CDA [5,28]. Our previous study also revealed that the HO incidence rate in 2-level HS groups was higher than for that of the 1-level CDA [13]. We thus infer that the overall HO occurrence in HS differs from single-level CDA.…”

Section: Discussionmentioning

confidence: 69%

“…However, few studies have documented some adverse outcomes, including device displacement, expulsion, loosening or fracture, heterotopic ossification (HO), and anterior bone loss (ABL), were identified in CDA and HS [1,6,[9][10][11][12][13][14][15]. The mechanism of HO and ABL formation remains unknown, but studies have suggested that the occurrence of HO and ABL were both related to changes in biomechanical environment [16,17].…”

Section: Introductionmentioning

confidence: 99%

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Association between anterior bone loss and anterior heterotopic ossification in hybrid surgery

Líu

et al. 2020

BMC Musculoskelet Disord

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Background Hybrid surgery (HS) has become an alternative procedure for the treatment of multilevel cervical degenerative disc disease with satisfactory outcomes. However, some adverse outcomes have recently emerged, such as heterotopic ossification (HO) and anterior bone loss (ABL). Furthermore, HO was found mostly located in the posterior and lateral of the cervical intervertebral disc space. The mechanism of anterior heterotopic ossification (AHO) formation may be different, and its relationship with ABL was uncertain. Methods Radiographical and clinical outcomes of ninety-seven patients who had undergone contiguous two-level HS between December 2010 and December 2017 and with a minimum of 2-year follow-up were analyzed. Postoperative radiographs were evaluated and compared to the initial postoperative films to determine the incidence of ABL and AHO. Results The overall incidence rate of ABL was 44.3% (43/97). It was identified in 70.6% of AHO cases (33.3% mild, 41.7% moderate, 25.0% severe) and 38.8% of non-AHO cases (38.7% mild, 45.2% moderate, 16.1% severe). A significant association between ABL and AHO occurrence was found (P = 0.016). There was no significant difference in prosthesis–endplate depth ratio or disc space angle change between the AHO group and the non-AHO group (P > 0.05). Compared with data preoperatively, clinical outcome scores significantly improved after surgery in both the AHO and non-AHO groups, with no significant differences between the two groups (P > 0.05). Conclusion ABL was common in HS, and it related to AHO. The formation of AHO could be an integral part of postoperative bone remodeling, as well as ABL.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 69%

Section: Introductionmentioning

confidence: 99%

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Association between anterior bone loss and anterior heterotopic ossification in hybrid surgery

Líu

et al. 2020

BMC Musculoskelet Disord

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“…This experience allowed us to generate rational implantation strategies for multilevel CDR and HS. The safety profile and clinical outcomes of multilevel cervical spine surgery have been reported by our team before[ 16 - 18 ].…”

Section: Introductionmentioning

confidence: 96%

Surgical strategy used in multilevel cervical disc replacement and cervical hybrid surgery: Four case reports

Wang¹,

Meng²,

Liu³

et al. 2020

WJCC

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BACKGROUND Multilevel artificial cervical disc replacement and anterior hybrid surgery have been introduced as reliable treatments for multilevel cervical degenerative disc disease. Surgical techniques are important for resolving patients’ symptoms and maintaining the normal functioning of cervical implants. However, the use of inappropriate surgical strategies could lead to complications such as implant migration and neurological deficit. In this paper, we summarize our surgical strategies used in multilevel cervical disc replacement and hybrid surgery into five major notes. CASE SUMMARY We share the key notes and our surgical procedures in the form of four typical case presentations. All patients were diagnosed with cervical degenerative disc disease with myelopathy or radiculopathy and needed multilevel cervical spine surgery. The first case demonstrated that index levels indicating the presence of highly serious spinal cord compression required a prioritized decompression. The second case demonstrated that the disc replacement should be performed before fusion in cervical hybrid surgery. The third and forth cases demonstrated that a top-down implantation sequence was needed in continuous two-level cervical disc replacement. The symptoms of all patients were significantly relieved after surgery. CONCLUSION We hope that our surgical strategies can help improve the performance and outcomes of multilevel cervical spine surgery.

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“…But in the procedure of TLIF, the facet joint need to be remove on one side or double side, which may lead to unstable vertebral body. Therefore, an internal fixation device is often used to maintain stability in the lumbar segment [1,2]. However, in patients with osteoporosis, conventional pedicle screws (CPS) have the disadvantage of insufficient holding power and bone cement needs to be used to strengthen the pedicle screw fixation to reduce the risk of screw loosening and pseudoarthrosis [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Influence of cement-augmented pedicle screw instrumentation in an osteoporotic lumbosacral spine over the adjacent segments: a 3D finite element study

Zhou

Zeng

et al. 2020

J Orthop Surg Res

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To compare the effect of conventional pedicle screw (CPS) and cement-augmented pedicle screw instrumentation (CAPSI) on adjacent segment degeneration (ASD). Methods: A normal male volunteer without a history of spinal disease was selected, lumbar CT data was collected, an intact L3-S1 three-dimensional finite element model was created by software including Mimics, Geomagic, and SolidWorks, and the fixation methods were performed accordingly. A common pedicle screw model and a cementaugmented pedicle screw model of L4-L5 with fusion and internal fixation were constructed. With ANSYS Workbench 17.0, a 500 N load was applied to the upper surface of L3 to simulate the weight of a human body, and a 7.5 N m moment was applied at the neutral point to simulate flexion, extension, left/right bending, left/right rotation of the spine. The peak von Mises stress of intervertebral disc and the range of motion (ROM) on the adjacent segments (L3-4 and L5-S1) were compared. Results: The validity of the intact model shows that the ROM of the model is similar to that of a cadaveric study. Compared with the intact model, CPS model and CAPSI model in all motion patterns increased the ROM of adjacent segments. The intervertebral disc stress and the ROM of adjacent segments were found to be higher in the CAPSI model than in the CPS model, especially in L3-4. Conclusion: In general, the biomechanical analysis of an osteoporotic lumbar spine showed that both CPS and CAPSI can increase the ROM and disc stresses of osteoporotic lumbar models, and compared with CPS, CAPSI is more likely to increase the potential risk of adjacent segment degeneration.

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Influence of Fusion on the Behavior of Adjacent Disc Arthroplasty in Contiguous 2-Level Hybrid Surgery In Vivo

Cited by 10 publications

References 31 publications

Association between anterior bone loss and anterior heterotopic ossification in hybrid surgery

Association between anterior bone loss and anterior heterotopic ossification in hybrid surgery

Surgical strategy used in multilevel cervical disc replacement and cervical hybrid surgery: Four case reports

Influence of cement-augmented pedicle screw instrumentation in an osteoporotic lumbosacral spine over the adjacent segments: a 3D finite element study

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