Clinical Significance of Heterotopic Ossification in Cervical Disc Replacement: A Prospective Multicenter Clinical Trial

Neurosurgery ◽  
2005 ◽  
Vol 57 (4) ◽  
pp. 759-763 ◽  
Author(s):  
Clarence Leung ◽  
Adrian Th. Casey ◽  
Jan Goffin ◽  
Pierre Kehr ◽  
Klaus Liebig ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heterotopic Ossification ◽  
Short Form ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Secondary Outcome ◽  
X Rays ◽  
Cervical Disc Replacement ◽  
Bryan Disc ◽  
Grade 3

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.

scholarly journals NuNec™ Cervical Disc Arthroplasty Improves Quality of Life in Cervical Radiculopathy and Myelopathy: A 2-yr Follow-up

Neurosurgery ◽  
2017 ◽  
Vol 83 (3) ◽  
pp. 422-428 ◽  
Author(s):  
Isobel Turner ◽  
David Choi
Keyword(s):  
Heterotopic Ossification ◽  
Clinical Outcomes ◽  
Short Form ◽  
Neck Disability Index ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Range Of Movement ◽  
Short Form 36 ◽  
Cervical Disc Replacement ◽  
Neck Disability

Abstract BACKGROUND Anterior cervical disc replacement is an alternative to fusion for the treatment of selected cases of radiculopathy and myelopathy. We report clinical and radiological outcomes after disc replacement with the NuNec™ artificial cervical disc (Pioneer® Surgical Technology, Marquette, Michigan) with subgroup analysis. OBJECTIVE To review clinical and radiological outcomes after anterior cervical disc replacement with the NuNec™ artificial cervical disc. METHODS A consecutive case series of patients undergoing cervical disc replacement with the NuNec™ artificial disc was conducted. Clinical outcomes were assessed by questionnaires preoperatively and up to 2 yr postoperatively including neck and arm pain, Neck Disability Index, Euroqol 5-dimensions, and Short Form-36; x-rays from the same period were analyzed for range of movement and presence of heterotopic ossification. RESULTS A total of 44 NuNec™ discs were implanted in 33 patients. Clinical improvements were seen in all outcomes; significant improvements on the Neck Disability Index, Euroqol 5-dimensions, and physical domain of the Short Form-36 were maintained at 2 yr. There was a mean of 4° range of movement at the replacement disc level at 2 yr, a significant reduction from baseline; there was also progression in levels of heterotopic ossification. Complications included temporary dysphagia (10%) and progression of disease requiring foraminotomy (6%); no surgery for adjacent level disease was required. There was no significant difference in the outcomes of the radiculopathy and myelopathy groups. CONCLUSION Clinical outcomes using the NuNec™ disc replacement are comparable with other disc replacements. Although the range of movement is reduced, the reoperation rate is very low.

Is Anterior Bone Loss the Opposite of Anterior Heterotopic Ossification in Prestige-LP Cervical Disc Replacement?

2020 ◽  
Vol 136 ◽  
pp. e407-e418 ◽  
Author(s):  
Xiaofei Wang ◽  
Yang Meng ◽  
Hao Liu ◽  
Ying Hong ◽  
Beiyu Wang
Keyword(s):  
Bone Loss ◽  
Heterotopic Ossification ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement

Effects of Treatment for Cervical Disc Degenerative Disease in Military Populations

2011 ◽  
Author(s):  
Joseph Cochran ◽  
Jamie L. Baisden ◽  
Narayan Yoganandan ◽  
Frank A. Pintar
Keyword(s):  
Finite Element ◽  
Degenerative Disease ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement ◽  
Bony Fusion ◽  
Bryan Disc ◽  
Cadaver Studies ◽  
External Forces ◽  
Military Patients

Numerous clinical and biomechanical evaluations of cervical disc replacement and anterior cervical discectomy and fusion as treatment of cervical disc herniation have been performed. Military patients represent a unique patient population as they may be subject to large external forces in theatre. Military patients are more susceptible to degenerative disease of the cervical spine, and if treated with single-level bony fusion, the treated level may be subject to large forces postoperatively. Literature reviews were conducted to determine patient outcomes following cervical disc replacement compared to bony fusion surgery; compare cadaver studies that evaluated the two conditions; and finite element modeling studies. In the civilian population, patients treated with each type of surgery have clinical improvement that is at least equivalent in the 2- and 5-year follow-up periods. Based on the finite element and cadaver biomechanical studies, semiconstrained devices, ProDisc-C and Prestige, are less mobile and a larger load is placed on the core of the device in comparison to the more mobile and unconstrained Bryan disc.

scholarly journals Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yi-Wei Shen ◽  
Yi Yang ◽  
Hao Liu ◽  
Xin Rong ◽  
Chen Ding ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heterotopic Ossification ◽  
Potential Risk ◽  
Disc Height ◽  
Cervical Disc ◽  
Combined Effects ◽  
Cervical Disc Replacement ◽  
Depth Ratio ◽  
Potential Risk Factors ◽  
Height Change

Abstract Background Heterotopic ossification (HO) is a common complication after cervical disc replacement (CDR). Biomechanical factors including endplate coverage and intervertebral disc height change may be related to HO formation. However, there is a dearth of quantitative analysis for endplate coverage, intervertebral height change and their combined effects on HO. Methods Patients who underwent single-level or two-level CDR with Prestige-LP were retrospectively reviewed. Clinical outcomes were evaluated through Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, and visual analogue scale (VAS) score. Radiological data, including the prosthesis-endplate depth ratio, intervertebral height change, posterior heterotopic ossification (PHO) and angular parameters, were collected. Logistic regression analysis was used to identify the potential risk factors. Receiver operating characteristic curves were plotted and the cut-off values of each potential factors were calculated. Results A total of 138 patients with 174 surgical segments were evaluated. Both the prosthesis-endplate depth ratio (P < 0.001) and post-operative disc height change (P < 0.001) were predictive factors for PHO formation. The area under the curve (AUC) of the prosthesis-endplate depth ratio, disc height change and their combined effects represented by the combined parameter (CP) were 0.728, 0.712 and 0.793, respectively. The risk of PHO significantly increased when the prosthesis-endplate depth ratio < 93.77% (P < 0.001, OR = 6.909, 95% CI 3.521–13.557), the intervertebral height change ≥ 1.8 mm (P < 0.001, OR = 5.303, 95% CI 2.592–10.849), or the CP representing the combined effect < 84.88 (P < 0.001, OR = 10.879, 95% CI 5.142–23.019). Conclusions Inadequate endplate coverage and excessive change of intervertebral height are both potential risk factors for the PHO after CDR. Endplate coverage less than 93.8% or intervertebral height change more than 1.8 mm would increase the risk of PHO. The combination of these two factors may exacerbate the non-uniform distribution of stress in the bone-implant interface and promote HO development.

Effect of Disc Height and Degree of Distraction on Heterotopic Ossification After Cervical Disc Replacement

2021 ◽  
Vol 145 ◽  
pp. e100-e107
Author(s):  
Xiaofei Wang ◽  
Hao Liu ◽  
Yang Meng ◽  
Ying Hong ◽  
Beiyu Wang ◽  
...  
Keyword(s):  
Heterotopic Ossification ◽  
Disc Height ◽  
Disc Replacement ◽  
Cervical Disc ◽  
Cervical Disc Replacement
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