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Comparing Heterotopic Ossification in Two Cervical Disc Prostheses.

Xiaoyu Yang1, Roland Donk2, Ronald H M A Bartels3

  • 1Department of Neurosurgery, Leiden University Medical Centre, Leiden, The Netherlands.

Spine
|June 25, 2020
PubMed
Summary
This summary is machine-generated.

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Heterotopic ossification (HO) occurred similarly in patients receiving activC or Bryan cervical disc prostheses. Clinical outcomes were comparable, though the Bryan prosthesis offered greater global range of motion (ROM).

Area of Science:

  • Spine surgery
  • Orthopedic biomechanics
  • Biomaterials in medicine

Background:

  • Cervical arthroplasty aims to preserve segmental range of motion (ROM).
  • Significant controversy exists regarding the incidence of heterotopic ossification (HO) with different cervical disc prostheses.
  • Understanding HO development is crucial for evaluating prosthesis efficacy and patient outcomes.

Purpose of the Study:

  • To compare the incidence of heterotopic ossification (HO) between the activC and Bryan cervical disc prostheses.
  • To evaluate clinical outcomes, including neck disability index (NDI), and range of motion (ROM) after implantation of these prostheses.
  • To investigate the relationship between prosthesis design and HO development.

Main Methods:

  • Retrospective analysis of data from two randomized clinical trials (NECK and PROCON).

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  • Patients underwent anterior cervical discectomy with either the activC or Bryan prosthesis for cervical radiculopathy.
  • HO was assessed using the McAfee-Mehren classification at 12 and 24 months postoperatively. ROM and clinical outcomes (NDI, PCS, MCS) were also measured.
  • Main Results:

    • At 2-year follow-up, HO incidence was 68% for activC (55% severe) and 85% for Bryan (44% severe), with no significant difference (P=0.12).
    • HO progression was similar between the two groups.
    • While the Bryan group showed significantly greater global ROM (56.4° vs. 49.5°, P=0.044), clinical outcomes (NDI, PCS, MCS) were comparable between groups.

    Conclusions:

    • Cervical disc prosthesis architecture does not influence the development of heterotopic ossification.
    • Although the Bryan prosthesis provided greater global ROM, this difference was not considered clinically significant.
    • Patient clinical condition was comparable regardless of HO severity, suggesting HO may not be a primary determinant of outcome.