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Comparative Study
Comparison of heterotopic ossification after fixed- and mobile-core cervical disc arthroplasty.
- Junfeng Zeng, Hao Liu, Hua Chen, Chen Ding, Xin Rong, Yang Meng, and Yi Yang.
- Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
- World Neurosurg. 2018 Dec 1; 120: e1319-e1324.
ObjectiveTo compare the heterotopic ossification (HO) between cervical disc arthroplasty (CDA) with fixed- and mobile-core prosthesis and to compare the clinical and radiographic outcomes.MethodsThis was a retrospective analysis of patients who underwent CDA in our institute. Patients were divided into a fixed-core group (Prodisc-C and Discover disc) and mobile-core group (Bryan and Prestige-LP disc). HO was assessed based on the McAfee classification. The visual analogue scale, Neck Disability Index, and Japanese Orthopaedic Association scores were used to evaluate clinical outcomes. In addition, radiographic assessments included cervical sagittal alignment (C2-C7 angle), segmental angle, and range of motion of the index level.ResultsA total of 218 patients were included with a minimal follow-up of 24 months. There were 137 patients in mobile-core group (Prestige-LP, 102; Bryan, 35) and 81 patients in the fixed-core group (Discover, 43; and Prodisc-C, 38). The mean follow-up time was 46.8 months. At the final follow-up, the overall incidence of HO was 39.9%. The incidence of HO in the fixed-core group was significantly greater than that in the mobile-core group (50.6% vs. 33.6%, P = 0.013). However, there were no significant differences in visual analogue scale, Neck Disability Index, or Japanese Orthopaedic Association scores, C2-C7 angle, segmental angle, or range of motion of the index level between the 2 groups.ConclusionsThe fixed-core prosthesis had a greater incidence of HO than mobile-core prosthesis after CDA. However, both CDA with fixed- and mobile-core prostheses obtained good clinical outcomes and maintained cervical sagittal alignment.Copyright © 2018 Elsevier Inc. All rights reserved.
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