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

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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#   

  1. Department of Orthopedics, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
  • Received:2019-07-22 Revised:2019-09-15 Online:2020-06-06 Published:2020-06-06
  • Contact: OU Yun-sheng E-mail:ouyunsheng2011@163.com

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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