The predisposing factors for the heterotopic ossification after cervical artificial disc replacement

Yi, Seong; Shin, Dong Ah; Choi, Gwihyun; Shin, Hocheol; Kh, Kim; Yoon, Doe Hyun

doi:10.1016/j.spinee.2013.02.036

Cited by 82 publications

(67 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Male gender has previously been reported to correlate with HO formation [35] and could be a contributing factor regarding the observed difference in HO occurrence compared with other reports. However, the present male/female ratio was not much different from the other studies.…”

Section: Discussionmentioning

confidence: 72%

Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)

et al. 2016

View full text Add to dashboard Cite

Purpose Heterotopic ossification is a phenomenon in cervical arthroplasty. Previous reports have mainly focused on various semiconstrained devices and only a few publications have focused on ossification around devices that are nonconstrained. The purpose of this study was to assess the occurrence of heterotopic ossification around a nonconstrained cervical device and how it affects clinical outcome 2 years after surgery. Methods Thirty-seven patients were included from a larger cohort of a randomized controlled trial (NORCAT) which compared single-level cervical arthroplasty with fusion. The occurrence of heterotopic ossification was assessed with a CT scan and two neuroradiologists determined its degree. For grading, we used the Mehren/Suchomel classification system (grade 0-4). The patients were divided by level of ossification, low grade (0-2) or high grade (3-4), and clinical outcomes were compared.Self-rated disability for neck and arm pain (Neck Disability Index), health-related quality of life (the Short Form-36 and EuroQol-5D), and pain (the Numeric Rating Scale 11) were used as clinical outcome measures. Results Heterotopic ossification was encountered in all patients 2 years after surgery. Complete fusion (grade 4) was found in 16 % of participants, and high-grade ossification (grade 3-4) occurred in 62 %. The remaining patients were classified as having low-grade ossification (grade 2). There were no differences in the clinical outcomes of patients with low-and high-grade ossification. Conclusion High-grade heterotopic ossification and spontaneous fusion 2 years after surgery were seen in a significant number of patients. However, the degree of ossification did not influence the clinical outcome.

show abstract

Section: Discussionmentioning

confidence: 72%

Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Qureshi et al analysed the cost-effectiveness comparing single level TDR and ACDF and conclude also that cTDR and ACDF are cost-effective procedures, but cTDR must remain functional for at least 14 years to establish greater cost-effectiveness than ACDF [34]. The appearance of HO right up to solid fusion (Grade 4) is a well known complication in cervical total disc replacement which can affect the motion, respectively, the function of the prosthesis [31,32,35] regardless the implant-type [7,11,17,27,28,[36][37][38][39]. The progression of HO into higher grades over time was also seen in other studies [28,32].…”

Section: Adjacent Segment Degenerationmentioning

confidence: 99%

“…Up to now there is no study available that could demonstrate a significant effect of the use of NSAID in the early post-operative period to avoid or reduce the incidence of HO. Nevertheless, at least a trend toward less HO formation and fewer immobile discs in patients who used NSAID's after could be observed [29,39,40]. Further possible underlying causes for the high incidence of heterotopic ossifications may include the preparation of the end plates as well as the opening of the cortex resulting from the chiseling of the keels during implant insertion [39,41].…”

Section: Adjacent Segment Degenerationmentioning

confidence: 99%

“…Nevertheless, at least a trend toward less HO formation and fewer immobile discs in patients who used NSAID's after could be observed [29,39,40]. Further possible underlying causes for the high incidence of heterotopic ossifications may include the preparation of the end plates as well as the opening of the cortex resulting from the chiseling of the keels during implant insertion [39,41]. Future studies should therefore investigate whether further developments and design changes which serve to avoid damages to the vertebral body surface may ultimately reduce the incidence of heterotopic ossifications.…”

Section: Adjacent Segment Degenerationmentioning

confidence: 99%

See 1 more Smart Citation

Clinical and radiological outcome at 10 years of follow-up after total cervical disc replacement

et al. 2017

View full text Add to dashboard Cite

“…13,20,32,33 The risk factors for HO remain controversial and diverse in previously reported series and included surgical indication, operative level, male sex, hybrid constructs, surgical technique, and method of detection. 8,19,32,33,[38][39][40][41] It was once reported that segmental ROM might be associated with the incidence of HO formation, but the study did not take HO severity into consideration and failed to address the changes in ROM. 27 The current study might add to the literature, in that decreased mobility (DROM < 0°) is another risk factor for HO.…”

Section: Figmentioning

confidence: 99%

Can segmental mobility be increased by cervical arthroplasty?

Chang

et al. 2017

FOC

View full text Add to dashboard Cite

OBJECTIVE Many reports have successfully demonstrated that cervical disc arthroplasty (CDA) can preserve range of motion after 1- or 2-level discectomy. However, few studies have addressed the extent of changes in segmental mobility after CDA or their clinical correlations. METHODS Data from consecutive patients who underwent 1-level CDA were retrospectively reviewed. Indications for surgery were medically intractable degenerative disc disease and spondylosis. Clinical outcomes, including visual analog scale (VAS)–measured neck and arm pain, Neck Disability Index (NDI), and Japanese Orthopaedic Association (JOA) scores, were analyzed. Radiographic outcomes, including C2–7 Cobb angle, the difference between pre- and postoperative C2–7 Cobb angle (ΔC2–7 Cobb angle), sagittal vertical axis (SVA), the difference between pre- and postoperative SVA (ΔSVA), segmental range of motion (ROM), and the difference between pre- and postoperative ROM (ΔROM), were assessed for their association with clinical outcomes. All patients underwent CT scanning, by which the presence and severity of heterotopic ossification (HO) were determined during the follow-up. RESULTS A total of 50 patients (mean age 45.6 ± 9.33 years) underwent a 1-level CDA (Prestige LP disc) and were followed up for a mean duration of 27.7 ± 8.76 months. All clinical outcomes, including VAS, NDI, and JOA scores, improved significantly after surgery. Preoperative and postoperative ROM values were similar (mean 9.5° vs 9.0°, p > 0.05) at each indexed level. The mean changes in segmental mobility (ΔROM) were −0.5° ± 6.13°. Patients with increased segmental mobility after surgery (ΔROM > 0°) had a lower incidence of HO and HO that was less severe (p = 0.048) than those whose ΔROM was < 0°. Segmental mobility (ROM) was significantly lower in patients with higher HO grade (p = 0.012), but it did not affect the clinical outcomes. The preoperative and postoperative C2–7 Cobb angles and SVA remained similar. The postoperative C2–7 Cobb angles, SVA, ΔC2–7 Cobb angles, and ΔSVA were not correlated to clinical outcomes after CDA. CONCLUSIONS Segmental mobility (as reflected by the mean ROM) and overall cervical alignment (i.e., mean SVA and C2–7 Cobb angle) had no significant impact on clinical outcomes after 1-level CDA. Patients with increased segmental mobility (ΔROM > 0°) had significantly less HO and similarly improved clinical outcomes than those with decreased segmental mobility (ΔROM < 0°).

show abstract

The predisposing factors for the heterotopic ossification after cervical artificial disc replacement

Cited by 82 publications

References 35 publications

Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)

Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)

Clinical and radiological outcome at 10 years of follow-up after total cervical disc replacement

Can segmental mobility be increased by cervical arthroplasty?

Contact Info

Product

Resources

About