Difference in Occurrence of Heterotopic Ossification According to Prosthesis Type in the Cervical Artificial Disc Replacement

Yi, Seong; Kh, Kim; Yang, Moon Sul; Yang, Joong Won; Kim, Hoon; Ha, Yoon; Yoon, Do Heum; Shin, Hocheol

doi:10.1097/brs.0b013e3181c6526b

Cited by 121 publications

(103 citation statements)

References 13 publications

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“…Follow-up ranged from 24 to 96 months and the occurrence of HO ranged from 37.5 to 62 %. An early study of HO with the Bryan Cervical Disc [12] found that 17.8 % of the patients had developed HO 12 months after surgery. Yi et al [13] assessed HO after 20 months in both nonconstrained and semiconstrained devices.…”

Section: Discussionmentioning

confidence: 99%

“…After the introduction of cervical arthroplasty, Mehren et al [10] published their classification system based on McAfee et al [9]. The degree of HO is described as low (grade 0-2) or high (grade 3-4) [10], and in the last decade several reports have been published in which the occurrence rate of HO varies according to the disc prosthesis used [11][12][13]. Cervical arthroplasty devices are usually manufactured to be semiconstrained or nonconstrained.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2016

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“…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%

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

et al. 2017

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“…In our study, 89.2 % of patients had an ossification Cgrade I at the 5-year follow-up. Many publications, however, reported that HO was not affecting clinical improvement [6,[19][20][21][22][23][24]. The clinical relevance of the low grade ossifications is questionable.…”

Section: Pain Relief Medication Consumption and Quality Of Lifementioning

confidence: 99%

Five-Year Results of Cervical Disc Prostheses in the SWISSspine Registry

Aghayev¹,

Baerlocher²,

Hasdemir³

et al. 2012

The Spine Journal

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Background The Swiss Federal Office of Public Health demanded a nationwide HTA-registry for cervical total disc arthroplasty (TDA), to decide about its reimbursement. The goal of the SWISSspine registry is to generate evidence about the safety and efficiency of cervical TDA. Materials and methods Three hundred thirty-two cases treated between 3.2005 and 6.2006 who were eligible for 5 years follow-ups were included in the study. Follow-up rates for 3-6 months, 1, 2 and 5 years were 84.6, 74.4, 50.6 and 64.8 %, respectively. Outcome measures were neck and arm pain, medication, quality of life, intraoperative and postoperative complication and revision rates. In addition, segmental mobility, ossification, adjacent and distant segment degeneration were analyzed at the 5-year follow-up. Results There was significant, clinically relevant and lasting reduction of neck (preop/postop 60/21 VAS points) and arm pain (preop/postop VAS 67/17) and a consequently decreased analgesics consumption and quality of life improvement (preop/postop 0.39/0.82 EQ-5D points) until the 5-year follow-up. The rates for intraoperative and early postoperative complications were 0.6 and 7.2 %, respectively. In 0.6 % an early and in 3.9 % a late revision surgery was performed. At the 5-year follow-up, the average range of motion of the mobile segments (88.2 %) was 10.2°. In 40.7 % of the patients osteophytes at least potentially affecting range of motion were seen. Conclusions Cervical TDA appeared as safe and efficient in long-term pain alleviation, consequent reduction of pain killer consumption and in improvement of quality of life. The improvement is stable over the 5 years postoperative period. The vast majority of treated segments remained mobile after 5 years, although 40.7 % of patients showed osteophytes.

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Difference in Occurrence of Heterotopic Ossification According to Prosthesis Type in the Cervical Artificial Disc Replacement

Abstract: Occurrence of HO is an inevitable postoperative complication after cervical ADR. The occurrence rate of HO was higher than our expectation. Moreover, definite differences in occurrence rate according to the prosthesis type were identified by this study.

Cited by 121 publications

References 13 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

Five-Year Results of Cervical Disc Prostheses in the SWISSspine Registry

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