Abstract
ABSTRACT Objective: This study was designed to evaluate the prevalence and grading of heterotopic ossification (HO) at five years, among patients after cervical disk arthroplasty (CDA). Methods: The CDA procedure with Activ C and M6-C prostheses was performed on 127 patients. The mean age of the cohort of patients was 38.4 years (range 18-49). The mean follow-up time was 58.4 months, ranging from 51 to 66 months. Results: Grade 1 ossifications were present in 11 (8.6 %) levels. A total of 45 (35.4 %) segments showed grade 2 HO. HO that led to restrictions in range of motion were present in 13 (10.2 %) cases. Five years after surgery, 9 (7.0 %) patients with grade 4 ossifications were found only in the M6-C artificial disk prosthesis group. In the analysis of patient survival following the occurrence of HO, all patients showed median survival of 28.3±5.6 months. The group that received the Activ C artificial disk prosthesis showed statistically longer survival (49.5±7.8 months) than the M6-C disk group. Conclusions: In our study 61.4% of patients exhibited HO after a mean follow-up of 58.4 months. In the analysis of patient survival after HO, all patients showed median survival of 28.3±5.6 months. The group that received the Activ C artificial disk prosthesis showed statistically longer survival (49.5±7.8 months) than the M6-C disk group. Level of evidence III; Cross-sectional Observational Study.
Highlights
Anterior cervical diskectomy and fusion (ACDF) is the gold standard for surgical treatment of cervical degenerative disk disease, and has shown long-term clinical success.[1,2] In recent years, cervical disk arthroplasty (CDA) has become widely used in patients as a substitute for ACDF.[3]
The CDA procedure with Activ C and M6-C prostheses was performed on 127 patients
Sheffield, UK) and M6-C (Spinal Kinetics, Sunnyvale, CA, USA) prostheses was performed from January 2009 to June 2011, on 127 patients, including 65 (51.1 %) women and 62 (48.8 %) men with symptomatic cervical disk degenerative disease but who had not responded to conservative treatment
Summary
Anterior cervical diskectomy and fusion (ACDF) is the gold standard for surgical treatment of cervical degenerative disk disease, and has shown long-term clinical success.[1,2] In recent years, cervical disk arthroplasty (CDA) has become widely used in patients as a substitute for ACDF.[3]. Heterotopic ossification (HO) and spontaneous fusion after CDA have been reported, and maintenance of motion following arthroplasty can be hindered by the development of HO.[8] HO is defined as the formation of bone outside the skeletal system. It is a well-known phenomenon in the field of total hip or knee arthroplasty and immobilized the activity of patients after surgery.[9] McAfee et al.,[10] have already described and classified the phenomenon of HO in lumbar total disk arthroplasty. The long-term effects of HO resulting in unintended fusion have not been sufficiently studied
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