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Abstract Objective To determine the incidence of long term paravertebral ossification (PO)after cervical artificial disc replacement (CADR)in patients with simple cervical disc herniation，and to analyze the influencing factors of mid to high grade PO in the long term after CADR.Methods A retrospective analysis of 28 patients who underwent Bryan artificial disc replacement for cervical disc herniation in our hospital from December 2003 to December 2007 was conducted. The patients were followed up for more than 10 years.The study included 16 males and 12 females patients with an average age of (54.21±8.7)，ranged from 37 to 64 years.There were 1 case at C3～4，4 at C4~5，19 at C5～6，and 4 at C6～7.According to the PO grade of the surgical segment at the last follow-up，the patients were divided into low-grade group and mid to high-grade group.The overall cervical spine range of motion (ROM)，surgical segment ROM，surgical segment curvature，artificial disc angle，prosthesis coverage ratio，neck disability index (NDI)，Japanese Orthopedic Association score (JOA)，Odom’s criteria were compared between the two groups of patients.The multivariate logistic regression analysis was used to explore the risk factors for the formation of mid-to-high-grade PO in the long-term after CADR.Results There were 11 cases in the low-grade group，17 cases in the mid-to-high-grade group.The occurrence of mid-to-high-grade PO was 60.7%.The age of the patients in the low-grade group was (53.55±8.54)，the preoperative segmental curvature was (2.88±0.98)°，and the preoperative operative segmental ROM was (10.10±4.60)°.The segmental ROM at 3 months follow-up was (12.84±3.52)°，the surgical segmental curvature at the last follow-up was (2.56±1.21)°，segmental ROM was (12.55±3.51)°；The age of the mid-to-high-grade group was (54.65±9.08)，and the preoperative segmental curvature was (2.14± 1.27)°，segment ROM was (9.15±4.82)°，surgical segment ROM was (9.98±3.33)° at 3 months postoperatively.At the last follow-up，the surgical segment curvature was (1.37±1.85)°，surgical segment ROM was (9.48±4.47)°.The operation segment ROM at 3 months follow-up of the low-grade group was significantly better than that of the mid-to-high-grade group (P＜0.05).The JOA improvement rate in the low-level group was (72.34±40.84)%，the NDI decreased by (11.64±7.58)%.The JOA improvement rate in the mid-to-high-grade group was (82.75±20.52)%，and the NDI decreased by (15.29±9.16)%.The clinical efficacy had no significant difference between the two groups.Multivariate logistic regression analysis showed that surgical segmental ROM at 3 months follow-up was an independent risk factor for mid-to-high-grade PO in the long-term after CADR (OR＝1.565，P＝0.047，95%CI：1.006~2.434).Conclusion Cervical artificial disc replacement has a satisfying long-term clinical effect in the treatment of cervical disc herniation.The reduction of ROM in the surgical segment at 3 months follow-up is an independent risk factor for mid-to-high-grade PO in the long-term after CADR.
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Zhang Bo,Wang Jinchao,Jiang Yuzhen, et al. Analysis of Influencing Factors of Long term Paravertebral Ossification After Cervical Artificial Disc Replacement in the Treatment of Cervical Disc Herniation[J]. sygkzz, 2022, 28(4): 289-294.
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| http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2022/V28/I4/289 |
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