Effect of heterotopic ossification&nbsp; on cervical motion following Prestige artificial cervical disc replacement

XU Shuai; XU Shuai Yun-Sheng; DU Xing; ZHU Yong; HE Bin; LI Yuan-Qiang; YU Hao-Yang

doi:10.16098/j.issn.0529-1356.2020.03.015

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Acta Anatomica Sinica ›› 2020, Vol. 51 ›› Issue (3) : 405-410. DOI: 10.16098/j.issn.0529-1356.2020.03.015

Effect of heterotopic ossification on cervical motion following Prestige artificial cervical disc replacement

XU Shuai OU Yun-sheng* DU Xing ZHU Yong HE Bin LI Yuan-qiang YU Hao-yang#br#

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Abstract

Objective To analyze the effect of heterotopic ossification(HO) on the postoperative segmental range of motion（ROM）after Prestige artificial cervical disc replacement, and to explore the related factors leading to the formation of heterotopic ossification after artificial cervical disc replacement. Methods We recruited of 66 patients who had Prestige artificial cervical disc replacement from January 2014 to January 2018 in Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University were retrospectively reviewed. To evaluate cervical spine X-ray, the replacement segment ROM was measured in picture,and the occurrence of HO was defined by the McAfee’s classification. The Wilcoxon signed rank test was used to analyze the relationship between heterotopic ossification formation and replacement segment ROM,the t test was used to analyze the influence between heterotopic ossification grading and replacement segment ROM. Nine clinical factors including age, gender, body mass index(BMI), number of replacement segments, preoperative ligament ossification, the preoperative disc height ratio of the target level and its adjacent level, preoperative mobility of replacement segments，postoperative mobility of replacement segments, whether to use nonsteroidal autiinflammatory drugs(NSAIDs) during perioperative period. The correlation between these nine clinical factors and the occurrence of postoperative HO was evaluated with logistic regression analysis. Results The occurrence rate of HO was 34.8％ in last follow-up. The replacement segmental ROM of the heterotopic ossification group was significantly smaller than that of the non-ectopic ossification group, and the difference was statistically significant (P<0.05)，and the McAfee grade Ⅲ-Ⅳ group was significantly less than the McAfee grade Ⅰ-Ⅱ group, and the difference was statistically significant (P<0.05).Correlation analysis showed that preoperative and postoperative ROM of the replacement segment presented statistical correlation（P＜0.05).Furthermore analysis of ROC curve showed that heterotopic ossification was more likely to occur when the degree of ROM of the replacement segment ≤8°. Conclusion HO after Prestige artificial cervical disc replacement reduces the replacement segmental ROM，especially for the McAfee grade Ⅲ-Ⅳgroup.The occurrence of heterotopic ossification after Prestige artificial cervical disc replacement is related to the preoperative and postoperative mobility of the replacement segment. The ROM≤8° of the postoperative replacement segment is more likely to occur heterotopic ossification.

Key words

Cervical vertebrae / Heterotopic ossification / Clinical factor / Range of motion / Prestige artificial cervical disc replacement / Human

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XU Shuai OU Yun-sheng DU Xing ZHU Yong HE Bin LI Yuan-qiang YU Hao-yang. Effect of heterotopic ossification on cervical motion following Prestige artificial cervical disc replacement[J]. Acta Anatomica Sinica. 2020, 51(3): 405-410 https://doi.org/10.16098/j.issn.0529-1356.2020.03.015

References

［1］ Matsumoto M, Okada E, Ichihara D, et al. Anterior cervical decompression and fusion accelerates adjacent segment degeneration: comparison with asymptomatic volunteers in a ten-year magnetic resonance imaging follow-up study［J］. Spine (Phila Pa 1976), 2010, 35(1): 36-43.

［2］ Yi S, Shin DA, Kim KN, et al.The predisposing factors for the heterotopic ossification after cervical artificial disc replacement［J］.Spine J，2013，13(9)：1048-1054.

［3］ Cason GW，Herkowitz HN. Cervical intervertebral disc replacement［J］.J Bone Joint Surg Am，2013,95（3）：279-285.

［4］ Lee JH, Jung TG, Kim HS，et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a ingle-level cervical artificial disc replacement［J］.Spine J，2010，10（8）；676-682.

［5］ Homel P, Jurak L, Benes V 3rd，et al. Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year fellow-up［J］.Eur Spine J, 2010，19（2）:307-315.

［6］ Sun Y, Zhao YB, Zhou FF, et al. Results of 5 years followup after Bryan cervical disc replacement ［J］. Chinese Journal of Spine and Spinal Cord, 2012, 22 (1):1-7.(in Chinese)

孙宇，赵衍斌，周非非,等.Bryan 颈椎人工椎间盘置换术后5 年随访结果［J］.中国脊柱脊髓杂志，2012，22（1）:1-7.

［7］ McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification(HO)in artificial disk replacement［J］.J Spinal Disord Tech，2003，16(4)：384-389.

［8］ White AA 3rd，Panjabi MM. The basic kinematics of the human spine. A review of past and current knowledge［J］.Spine (Phila Pa 1976)，1978，3(1): 12-20.

［9］ Zhou FF, Zhao YB, Sun Y, et al. Analysis of clinical factors of heterotopic ossification after Bryan cervical disc replacement ［J］.Chinese Journal of Spinal and Spinal Cord, 2009, 19 (1): 39-43. (in Chinese)

周非非，赵衍斌，孙宇，等. Bryan 人工颈椎间盘置换术后异位骨化形成的临床因素分析［J］. 中国脊柱脊髓杂志，2009，19(1): 39-43.

［10］ Jawahar A，Cavanaugh DA，Kerr EJ 3rd，et al. Total disc arthroplasty does not affecr the incidence of adjacent segment degeneration in cervical spine:results of 93 patients in three prospective randomized clinical trials［J］. Spine J，2010，10（12）:1043-1048.

［11］ Sasso RC，Anderson PA，Riew KD，et al. Results of cervical arthroplasty compared with anterior discectomy and fusion：four- year clinical outcomes in a prospective，randomized controlled trial［J］.J Bone joint Surg Am，2011,93（18）：1684-1692.

［12］ Tian W, Yan K, Han X, et al. The mid-term follow-up study of Bryan artificial bone replacement and anterior decompression fusion in the treatment of cervical degenerative diseases［J］. Chinese Orthopaedic Journal, 2013,33 (2):97-104. (in Chinese)

田伟，阎凯，韩骁,等.Bryan 人工间盘置换与前路减压融合治疗颈椎退行性疾病的中期随访研究［J］. 中华骨科杂志，2013，33（2）：97-104.

［13］ Mehren C, Suchomel P, Grochulla Fm, et al.Heterotopic ossification in total cervical artificial disc replacement［J］.Spine(Phila Pa 1976)，2006，31(24)：2802-2806.

［14］ Su Kim K, Hwaheo D. Do postoperative biomechanical changes induce heterotopic ossification after cervical arthroplasty? A 5 year follow-up study［J］. Clin Spine Surg, 2016, 29(6):E309-313.

［15］ Homel P, Jurak L, Benes V 3rd, et al. Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year fellowup［J］.Eur Spine J, 2010，19（2）:307-315.

［16］ Lee JH，Jung TG，Kim HS, et al. Analysis of the incidence and clinical effect of the heterotopic ossification in a single-level cervical artificial disc replacement［J］.Spine J，2010，10（8）：676-682.

［17］ Pierce D, Nunley MD, David A, et al. Heterotopic ossification after cervical total disc replacement at 7 years——prevalence, progression, clinical implications, and risk factors［J］.Int J Spine Surg, 2018, 12（3）:352-361.

［18］ Cao P, Qi M, Chen HJ, et al.The correlation between heterotopic ossification and the degree of facet joint degeneration after cervical disc replacement ［J］. Chinese Orthopaedic Journal, 2015, 35 (4):357-361.(in Chinese)

曹鹏，祁敏，陈华江，等、颈椎人工椎间盘置换术后异位骨化与小关节退变程度的相关性研究［J］. 中华骨科杂志，2015，35（4）：357-361.

［19］ Zhang GY, Zhu WR, Yang B, et al. Clinical anatomy of the facet joint puncture in adult cervical vertebra ［J］. Acta Anatomica Sinica, 2012，43（6）:789-791. (in Chinese)

张贵源，朱文仁，杨兵,等.成人颈椎小关节间隙穿刺路径的应用解剖［J］.解剖学报，2012，43（6）:789-791.