ANALYSIS OF EFFECTIVENESS AND INCIDENCE OF HETEROTOPIC OSSIFICATION AFTER SINGLE-LEVEL Bryan CERVICAL ARTIFICIAL DISC REPLACEMENT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

LIU Wenhua ¹ , ZHU Bing ¹ , LIU Xiaowei ¹ , SUN Yu ²

1Department of Spinal Surgery, the Affiliated Hospital of Weifang Medical College, Weifang Shandong, 261031, P.R.China;;
2Department of Orthopaedics, Peking University Third Hospital.;

Corresponding author：

Keywords：

Cervical artificial disc replacement; Heterotopic ossification; Cervical range of motion; Complication

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Objective To evaluate the incidence of heterotopic ossification (HO) after single-level Bryan cervical artificial disc replacement, and to identify the relationship between HO and the effectiveness. Methods The cl inical data of 48 patients undergoing single-level Bryan cervical artificial disc replacement between October 2005 and October 2007 were reviewed
retrospectively. There were 27 males and 21 females with an average age of 40.5 years (range, 33-51 years), including 8 cases of cervical myelopathy, 27 cases of nerve root cervical spondylosis, and 13 cases of mixed cervical spondylosis with an average disease duration of 10.3 months (range, 2-14 months). The involved segments included C3, 4 in 3 cases, C4, 5 in 6 cases, C5, 6 in 30 cases, and C6, 7 in 9 cases. The outcomes were evaluated using Visual Analogue Scale (VAS) score, the neck disabil ity index (NDI), and cervical range of motion (ROM). According to patients with or without HO, 48 patients were divided into 2 groups (HO group and no HO group). VAS score, NDI, and cervical ROM were compared between 2 groups at 1, 2, 3, and 4 years after operation. Results No severe complication occurred during and after operation in all patients. Forty-eight patients were followed up 48-72 months (mean, 56.6 months). VAS score and NDI were significantly improved when compared with preoperative values at all time points (P lt; 0.05); except at 3 days after operation, no significant difference was found in cervical ROM at the other time points when compared with preoperation (P gt; 0.05). Thirteen patients (27.08%) had HO at 4 years after operation, including 8 cases of grade 1, 3 cases of grade 2, and 2 cases of grade 3. There was no significant difference in VAS score, NDI, and cervical ROM between 2 groups at 1, 2, 3, and 4 years (P gt; 0.05). Conclusion The incidence of HO after single-level Bryan cervical artificial disc replacement is relatively high. However, HO has no effect on the cervical ROM and the effectiveness.

Citation： LIU Wenhua,ZHU Bing,LIU Xiaowei,SUN Yu. ANALYSIS OF EFFECTIVENESS AND INCIDENCE OF HETEROTOPIC OSSIFICATION AFTER SINGLE-LEVEL Bryan CERVICAL ARTIFICIAL DISC REPLACEMENT. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(6): 699-702. doi: Copy

1.
2.
3.	Bertagnoli R, Duggal N, Pickett GE, et al. Cervical total disc replacement, part two: clinical results. Orthop Clin North Am, 2005, 36(3): 355-362.
4.	Porchet F, Metcalf NH. Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial. Neurosurg Focus, 2004, 17(3): E6.
5.	Toyoda T, Matsumoto H, Tsuji T, et al. Heterotopic ossification after total knee arthroplasty. J Arthroplasty, 2003, 18(8): 760-764.
6.	McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389.
7.	Mehren C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806.
8.	刘忠军. 脊柱外科手术操作与技术. 北京: 人民卫生出版社, 2009: 26-27.
9.	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. 中国脊柱脊髓杂志, 2009, 19(1): 39-43.
10.	Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678.
11.	Wigfield C, Gill S, Nelson R, et al. Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg, 2002, 96(1 Suppl): 17-21.
12.	田伟, 刘波, 李勤, 等. Bryan人工颈椎间盘置换对颈椎功能影响的临床分析. 中华外科杂志, 2008, 46(5): 338-341.
13.	杨大龙, 申勇, 曹俊明, 等. 颈人工椎间盘置换近期并发症分析. 中国脊柱脊髓杂志, 2008, 18(4): 249-252.
14.	Leung C, Casey AT, Goffin J, et al. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(6): 759-763.
15.	孙宇, 潘胜发, 张凤山, 等. Bryan人工椎间盘置换术治疗颈椎病的近期临床效果及出现的问题. 中国脊柱脊髓杂志, 2008, 18(1): 13-17.
16.	Botelho RV, Moraes OJ, Fernandes GA, et al. A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus, 2010, 28(6): E5.
17.	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. Spine J, 2010, 10(8): 676-682.
18.	Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231.
19.	Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289.
20.	Sasso RC, Snmcker JD, Haeker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine (Phila Pa 1976), 2007, 32(26): 2933-2942．.
21.	Kim SW, Paik SH, Castro PA, et al. Analysis of factors that may influence range of motion after cervical disc arthroplasty. Spine J, 2010, 10(8): 683-688.
22.	Zechmeister I, Winkler R, Mad P. Artifi cial total disc replacement versusfusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184.

1.
2.
3. Bertagnoli R, Duggal N, Pickett GE, et al. Cervical total disc replacement, part two: clinical results. Orthop Clin North Am, 2005, 36(3): 355-362.
4. Porchet F, Metcalf NH. Clinical outcomes with the Prestige II cervical disc: preliminary results from a prospective randomized clinical trial. Neurosurg Focus, 2004, 17(3): E6.
5. Toyoda T, Matsumoto H, Tsuji T, et al. Heterotopic ossification after total knee arthroplasty. J Arthroplasty, 2003, 18(8): 760-764.
6. McAfee PC, Cunningham BW, Devine J, et al. Classification of heterotopic ossification (HO) in artificial disk replacement. J Spinal Disord Tech, 2003, 16(4): 384-389.
7. Mehren C, Suchomel P, Grochulla F, et al. Heterotopic ossification in total cervical artificial disc replacement. Spine (Phila Pa 1976), 2006, 31(24): 2802-2806.
8. 刘忠军. 脊柱外科手术操作与技术. 北京: 人民卫生出版社, 2009: 26-27.
9. 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. 中国脊柱脊髓杂志, 2009, 19(1): 39-43.
10. Goffin J, van Calenbergh F, van Loon J, et al. Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: single-level and bi-level. Spine (Phila Pa 1976), 2003, 28(24): 2673-2678.
11. Wigfield C, Gill S, Nelson R, et al. Influence of an artificial cervical joint compared with fusion on adjacent-level motion in the treatment of degenerative cervical disc disease. J Neurosurg, 2002, 96(1 Suppl): 17-21.
12. 田伟, 刘波, 李勤, 等. Bryan人工颈椎间盘置换对颈椎功能影响的临床分析. 中华外科杂志, 2008, 46(5): 338-341.
13. 杨大龙, 申勇, 曹俊明, 等. 颈人工椎间盘置换近期并发症分析. 中国脊柱脊髓杂志, 2008, 18(4): 249-252.
14. Leung C, Casey AT, Goffin J, et al. Clinical significance of heterotopic ossification in cervical disc replacement: a prospective multicenter clinical trial. Neurosurgery, 2005, 57(6): 759-763.
15. 孙宇, 潘胜发, 张凤山, 等. Bryan人工椎间盘置换术治疗颈椎病的近期临床效果及出现的问题. 中国脊柱脊髓杂志, 2008, 18(1): 13-17.
16. Botelho RV, Moraes OJ, Fernandes GA, et al. A systematic review of randomized trials on the effect of cervical disc arthroplasty on reducing adjacent-level degeneration. Neurosurg Focus, 2010, 28(6): E5.
17. 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. Spine J, 2010, 10(8): 676-682.
18. Kim SW, Limson MA, Kim SB, et al. Comparison of radiographic changes after ACDF versus Bryan disc arthroplasty in single and bi-level cases. Eur Spine J, 2009, 18(2): 218-231.
19. Du J, Li M, Liu H, et al. Early follow-up outcomes after treatment of degenerative disc disease with the discover cervical disc prosthesis. Spine J, 2011, 11(4): 281-289.
20. Sasso RC, Snmcker JD, Haeker RJ, et al. Artificial disc versus fusion: a prospective, randomized study with 2-year follow-up on 99 patients. Spine (Phila Pa 1976), 2007, 32(26): 2933-2942．.
21. Kim SW, Paik SH, Castro PA, et al. Analysis of factors that may influence range of motion after cervical disc arthroplasty. Spine J, 2010, 10(8): 683-688.
22. Zechmeister I, Winkler R, Mad P. Artifi cial total disc replacement versusfusion for the cervical spine: a systematic review. Eur Spine J, 2011, 20(2): 177-184.

Chinese Journal of Reparative and Reconstructive Surgery

ANALYSIS OF EFFECTIVENESS AND INCIDENCE OF HETEROTOPIC OSSIFICATION AFTER SINGLE-LEVEL Bryan CERVICAL ARTIFICIAL DISC REPLACEMENT

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