• World Neurosurg · Nov 2019

    Does Heterotopic Ossification in Cervical Arthroplasty Affect Clinical Outcome?

    • Xiaoyu Yang, Bartels Ronald H M A RHMA Department of Neurosurgery, Radboud University Medical Centre, Nijmegen, the Netherlands., Roland Donk, Bart Depreitere, Joris Walraevens, Zhiwei Zhai, and Vleggeert-Lankamp Carmen L A CLA Department of Neurosurgery, Leiden University Medical Centre, Leiden, the Netherlands..
    • Department of Neurosurgery, Leiden University Medical Centre, Leiden, the Netherlands. Electronic address: X.Yang@lumc.nl.
    • World Neurosurg. 2019 Nov 1; 131: e408-e414.

    ObjectiveTo investigate the occurrence and progression of heterotopic ossification (HO) in patients treated by anterior cervical discectomy with arthroplasty. It was evaluated if HO affects clinical outcome and range of motion (ROM). Risk factors of HO was studied as well.MethodsPatients who underwent anterior cervical discectomy with arthroplasty for a cervical radiculopathy because of a herniated disc from the NECK and PROCON trial were analyzed for HO at 12 and 24 months postoperatively. HO was scored according to the McAfee-Mehren classification. The index ROM was defined by a custom developed image analysis tool, and global cervical ROM was measured by Cobb's angle. Clinical outcome was evaluated by means of the Neck Disability Index and the 36-Item Short Form Health Survey.ResultsThe occurrence of HO was 60% at 1 year, and it increased to 76% at 2-year follow-up. A total of 31% of patients were scored as high-grade HO at 1-year follow-up, and this percentage increased to 50% at 2-year follow-up. Clinical outcome does not correlate to HO grade, and no risk factor for high-grade HO could be identified. The ROM at the index level was significantly higher in low-grade HO group than those patients with high-grade HO, but in 15%-38% HO grade does not correspond to ROM.ConclusionsHO occurs in three fourths of the patients at 2 years after surgery, but does not necessarily correspond to clinical outcome, nor loss or preservation of ROM. The McAfee-Mehren classification should be combined with ROM evaluation to properly study HO.Copyright © 2019 Elsevier Inc. All rights reserved.

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