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Heterotopic Ossification after Cervical Arthroplasty with ProDisc-C: Time Course Radiographic Follow-up over 3 years

Yong-Hwan Cho1, Keun-Su Kim2, Young-Min Kwon1

  • 1Department of Neurosurgery, Dong-A University College of Medicine, Busan, Korea.

Korean Journal of Spine
|April 24, 2014
PubMed

Insights

Heterotopic ossification (HO) after total cervical disc replacement (TCDR) increases over time, with significant HO developing in 56% by 36 months. Clinical outcomes improved despite HO progression.

Area of Science:

  • Orthopedics
  • Spine Surgery
  • Biomaterials

Background:

  • Heterotopic ossification (HO) is a known complication following hip replacement surgery.
  • The incidence, clinical impact, and risk factors of HO after total cervical disc replacement (TCDR) are not well-established.
  • Understanding HO after TCDR is crucial for patient management and surgical technique refinement.

Purpose of the Study:

  • To evaluate the time-course incidence of HO after TCDR using the ProDisc-C.
  • To identify potential risk factors associated with HO development post-TCDR.
  • To assess the clinical significance and correlation of HO with patient outcomes.

Main Methods:

  • A cohort of 32 patients undergoing TCDR with ProDisc-C and followed for over one year was retrospectively analyzed.
  • Radiographic assessments for HO were performed at 12, 24, and 36 months post-surgery using the McAfee classification.
  • Risk factors including range of motion, preoperative spondylosis, surgical details, and clinical outcomes (VAS, NDI) were evaluated.

Main Results:

  • HO was observed in 56% of patients at 12 months, increasing to 86% at 24 months and 89% at 36 months.
  • Clinically significant HO (Grade 3-4) developed in 3% at 12 months, 14% at 24 months, and 56% by 36 months.
  • Longer follow-up periods were associated with an increased risk of clinically significant HO, though all patients reported improved clinical parameters.

Conclusions:

  • The incidence of HO after TCDR progresses significantly over time.
  • Despite the high incidence of HO, there was no correlation found between radiologic changes (ROM, HO grade) and clinical outcomes.
  • The study highlights the need for continued monitoring and research into managing HO after TCDR.
Abstract

Keywords:
Cervical arthroplastyHeterotopic ossificationTotal disc replacement

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