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Is There a Relationship Between Bony Fusion After Anterior Cervical Discectomy and Fusion and Heterotopic Ossification After Cervical Disc Arthroplasty in Hybrid Surgery?

Abstract：

STUDY DESIGN:Retrospective analysis. OBJECTIVE:The aim of this study was to investigate the relationship between bony fusion after anterior cervical discectomy and fusion (ACDF) and heterotopic ossification (HO) after cervical disc arthroplasty (CDA) in hybrid surgery (HS). SUMMARY OF BACKGROUND DATA:The mechanism of postoperative bone formation still remains unknown. It is considered a risk factor in CDA but is essential for a solid union in ACDF. With HS, we could directly study the mechanism and relationship of different forms of postoperative bone formation. METHODS:Clinical data of 91 patients who had undergone consecutive two-level HS between January 2011 and January 2018 and with a minimum of 2-year follow-up was analyzed. HO was assessed based on McAfee's classifications, whereas fusion success was evaluated according the Food and Drug Administration approved criteria. Clinical outcomes and radiographic parameters were collected and used for the relevant comparisons. RESULTS:HO was identified in 48.4% of patients (44/91). The fusion rates of patients in the HO group and the non-HO group at 3, 6, and 12 months postoperatively, and the final follow-up were 81.8% and 19.1%, 95.4% and 74.5%, 95.4% and 85.1%, and 97.7% and 93.6%, respectively. The fusion rates were significantly higher at 3 and 6 months after operation in the HO group than in the non-HO group (P < 0.05). Patients in both groups had significant improvements across all clinical outcomes at final follow-up. CONCLUSION:There was a significant relationship between bony fusion and occurrence of HO after HS, suggesting that both bony fusion and HO are reflections of individual osteogenic capacity. However, a reliable predictor of postoperative bone formation is needed in the future to guarantee a solid bony fusion after ACDF and to further take full advantage of the motion-preserving from CDA. LEVEL OF EVIDENCE:3.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

He J,Ding C,Liu H,Wu T,Huang K,Wang B,Hong Y,Liu Y

doi

10.1097/BRS.0000000000003687

subject

Has Abstract

pub_date

2020-12-15 00:00:00

pages

E1653-E1660

issue

eissn

0362-2436

issn

1528-1159

pii

00007632-202012150-00007

journal_volume

pub_type

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Is There a Relationship Between Bony Fusion After Anterior Cervical Discectomy and Fusion and Heterotopic Ossification After Cervical Disc Arthroplasty in Hybrid Surgery?