P120. Risk factors for failure to achieve minimal clinically important difference following cervical disc replacement

ABSTRACT OBJECTIVE: Heterotopic ossification (HO) is a well-known complication in joint replacements, but its occurrence and clinical effect on cervical artificial discs has not yet been studied. The purpose of this study was to investigate the incidence of HO in cervical disc replacement, to identify any associated risk factors for HO, and to examine the relationship of HO with clinical outcomes. METHODS: The patient data for this observational study were obtained from the original Bryan Disc Study by the European Consortium. Occurrence of HO was defined by the McAfee classification on the cervical lateral x-rays at 12 months after surgery. Secondary outcome measurements included Odom's criteria and the Medical Outcomes Study Short-Form 36-Item Health Survey. RESULTS: Sixteen (17.8%) of the 90 studied patients experienced HO, and 6 (6.7%) of these patients experienced Grade 3 and 4 HO. Ten patients' (11%) artificial discs were shown to have movement of less than 2 degrees on flexion and extension cervical x-ray at 12 months, with 4 of these patients having HO of Grade 3 or 4. Male sex (χ2 = 4.1; P = 0.0407) and older patients (P = 0.023; odds ratio = 1.10; 95% confidence interval = 1.01–1.19) were associated with development of HO. CONCLUSION: There is a strong association of the occurrence of HO with subsequent loss of movement of the implanted cervical artificial disc. We have found that sex and age are two possible risk factors in the development of HO after cervical disc replacement.

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Mechanical failure of the Mobi-C implant for artificial cervical disc replacement: report of 4 cases

Journal of Neurosurgery Spine ◽

10.3171/2020.5.spine19442 ◽

2020 ◽

Vol 33 (6) ◽

pp. 727-733

Author(s):

Jasmine A. T. DiCesare ◽

Alexander M. Tucker ◽

Irene Say ◽

Kunal Patel ◽

Todd H. Lanman ◽

...

Keyword(s):

Cervical Spondylosis ◽

Case Series ◽

Dynamic Imaging ◽

Disc Replacement ◽

Cervical Disc ◽

Artificial Disc ◽

Younger Patients ◽

Cervical Disc Replacement ◽

Short And Long Term

Cervical spondylosis is one of the most commonly treated conditions in neurosurgery. Increasingly, cervical disc replacement (CDR) has become an alternative to traditional arthrodesis, particularly when treating younger patients. Thus, surgeons continue to gain a greater understanding of short- and long-term complications of arthroplasty. Here, the authors present a series of 4 patients initially treated with Mobi-C artificial disc implants who developed postoperative neck pain. Dynamic imaging revealed segmental kyphosis at the level of the implant. All implants were locked in the flexion position, and all patients required reoperation. This is the first reported case series of symptomatic segmental kyphosis after CDR.

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Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up. Suchomel P, Jurák L, Benes V 3rd, et al. Eur Spine J 2010;19(2):307–15. Epub 2009 Dec 25

The Spine Journal ◽

10.1016/j.spinee.2010.06.033 ◽

2010 ◽

Vol 10 (9) ◽

pp. 843

Keyword(s):

Heterotopic Ossification ◽

Clinical Results ◽

Disc Replacement ◽

Cervical Disc ◽

Cervical Disc Replacement

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Cervical disc replacement surgery: indications, technique, and technical pearls

Current Reviews in Musculoskeletal Medicine ◽

10.1007/s12178-017-9398-3 ◽

2017 ◽

Vol 10 (2) ◽

pp. 160-169 ◽

Cited By ~ 26

Author(s):

Dante Leven ◽

Joshua Meaike ◽

Kris Radcliff ◽

Sheeraz Qureshi

Keyword(s):

Disc Replacement ◽

Cervical Disc ◽

Cervical Disc Replacement ◽

Replacement Surgery

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Cervical sagittal alignment after Prestige LP cervical disc replacement: radiological results and clinical impacts from a single-center experience

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03962-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Xiaofei Wang ◽

Yang Meng ◽

Hao Liu ◽

Hua Chen ◽

Beiyu Wang ◽

...

Keyword(s):

Sagittal Alignment ◽

Disc Replacement ◽

Cervical Disc ◽

Adjacent Segment ◽

Single Center ◽

Disc Disease ◽

Sagittal Vertical Axis ◽

Cervical Disc Replacement ◽

Cervical Sagittal Alignment ◽

The Impact

Abstract Background Cervical disc replacement (CDR) has been widely used to treat one- and two-level cervical degenerative disc disease. Studies have shown the effectiveness of CDR in preserving range of motion (ROM) and delaying adjacent segment degeneration (ASD). Cervical sagittal alignment is an important factor affecting favorable clinical outcomes in cervical spine surgery. This study aimed to explore whether cervical sagittal alignment can be maintained after CDR and to identify the impact of cervical sagittal alignment on outcomes after CDR. Methods This was a single-center, retrospective study. 132 patients who underwent one-level CDR were included. Cervical sagittal alignments, including cervical lordosis (CL), segmental alignment (SA), sagittal vertical axis (SVA), T1 slope (T1s), and T1s minus CL (T1s-CL), were measured. The effects of cervical sagittal alignment on the CDR outcomes were analyzed. Patients were divided into the heterotopic ossification (HO) group and ASD group to determine the potential impacts of cervical sagittal parameters. Results The cervical sagittal alignment parameters, except for the SVA, were significantly improved after CDR and showed decreasing trends at the last follow-up. Significantly higher CL and T1s were found in patients with better ROM after CDR. SVA ≥ 20 mm increased the risk of anterior HO (odds ratio = 2.945, P = 0.007). Significantly kyphotic SA and lower T1s values were found in the ASD patients than in the non-ASD patients (P < 0.05). Patients with ASD at the inferior level showed significantly worse CL (P < 0.05). Conclusion CDR had limited function of improving cervical sagittal alignment. Poor cervical sagittal alignment after CDR was associated with HO, ASD, and less ROM.

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