• Spine · Sep 2012

    Multilevel arthroplasty for cervical spondylosis: more heterotopic ossification at 3 years of follow-up.

    • Jau-Ching Wu, Wen-Cheng Huang, Tzu-Yun Tsai, Li-Yu Fay, Chin-Chu Ko, Tsung-Hsi Tu, Ching-Lan Wu, and Henrich Cheng.
    • Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
    • Spine. 2012 Sep 15;37(20):E1251-9.

    Study DesignRetrospective cohort study.ObjectiveTo investigate the differences between single- and multilevel degenerative disc diseases (DDDs) treated with cervical arthroplasty.Summary Of Background DataThe US Food and Drug Administration clinical trials compared arthroplasty with anterior cervical discectomy and fusion for single-level DDD. However, cervical arthroplasty for multilevel DDD is rarely addressed in the literature.MethodsA total of 102 consecutive patients who underwent Bryan arthroplasty were divided into either a single- or multilevel group. Clinical outcomes were measured by the visual analogue scale (VAS) of neck and arm, and by the neck disability index with a minimum follow-up of 25 months. Every patient had radiographical evaluations, and computed tomography.ResultsEighty-six patients (84.3%) completed the follow-up with a mean time of 38.3 ± 8.7 months. Postoperatively, there were significant improvements in clinical outcomes (i.e., VAS neck, VAS arm, and neck disability index) at each time point of evaluation (i.e., 3-, 6-, 12-, and 24 mo postoperation). The sex composition and clinical outcome improvements between the single- and multilevel groups were not significantly different. The multilevel group was older (51.3 ± 8.6 vs. 46.3 ± 11.2 yr; P = 0.02), had more intraoperative blood loss (218.0 ± 182.4 vs. 102.8 ± 79.2 mL; P = 0.001), and demonstrated a higher rate of heterotopic ossification (HO) than the single-level group (66.0% vs. 25.0%; P < 0.001). The majority (97.7%) of the artificial discs in this series remained mobile despite HO.ConclusionClinical outcomes of cervical arthroplasty in multilevel spondylosis are similar to single-level outcomes. However, the significantly higher rate of HO found in multilevel arthroplasty and its long-term effect warrant further investigation.

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