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Direct Mouse Trauma/Burn Model of Heterotopic Ossification
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Does Heterotopic Ossification in Cervical Arthroplasty Affect Clinical Outcome?
Xiaoyu Yang1, Ronald H M A Bartels2, Roland Donk3
1Department of Neurosurgery, Leiden University Medical Centre, Leiden, the Netherlands.
World Neurosurgery
|August 4, 2019
Summary
Heterotopic ossification (HO) is common after anterior cervical discectomy with arthroplasty, affecting 76% of patients at two years. While HO can impact range of motion (ROM), it does not consistently correlate with clinical outcomes.
Area of Science:
- Spine surgery outcomes
- Orthopedic research
- Biomedical engineering
Background:
- Anterior cervical discectomy with arthroplasty is a surgical procedure for cervical radiculopathy.
- Heterotopic ossification (HO) is the abnormal formation of bone in soft tissues.
- The impact of HO on clinical outcomes and range of motion (ROM) after this procedure requires further investigation.
Purpose of the Study:
- To determine the incidence and progression of HO following anterior cervical discectomy with arthroplasty.
- To assess the relationship between HO and clinical outcomes, including ROM.
- To identify potential risk factors for HO development.
Main Methods:
- Analysis of patients from the NECK and PROCON trials who underwent anterior cervical discectomy with arthroplasty.
- Assessment of HO using the McAfee-Mehren classification at 12 and 24 months postoperatively.
- Measurement of index and global cervical ROM using specialized imaging analysis and Cobb's angle; clinical outcomes assessed via Neck Disability Index and SF-36.
Main Results:
- HO occurred in 60% of patients at 1 year, increasing to 76% at 2 years.
- High-grade HO was observed in 31% at 1 year and 50% at 2 years.
- No correlation was found between HO grade and clinical outcome; no risk factors for high-grade HO were identified. ROM was higher in low-grade HO groups, but HO grade did not always predict ROM.
Conclusions:
- HO is highly prevalent at two years post-anterior cervical discectomy with arthroplasty.
- HO does not consistently correlate with clinical outcomes or affect ROM preservation.
- Combining McAfee-Mehren classification with ROM evaluation is recommended for comprehensive HO assessment.
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