Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement

Abstract Background Heterotopic ossification (HO) is a common complication after cervical disc replacement (CDR). Biomechanical factors including endplate coverage and intervertebral disc height change may be related to HO formation. However, there is a dearth of quantitative analysis for endplate c...

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Autores principales:	Yi-Wei Shen, Yi Yang, Hao Liu, Xin Rong, Chen Ding, Yang Meng, Bei-Yu Wang, Ying Hong
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Cervical disc replacement Heterotopic ossification Endplate coverage Intervertebral height change Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/14164e02e9434e6794f1034b5217d61d
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spelling	oai:doaj.org-article:14164e02e9434e6794f1034b5217d61d2021-11-28T12:27:12ZEffects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement10.1186/s13018-021-02840-51749-799Xhttps://doaj.org/article/14164e02e9434e6794f1034b5217d61d2021-11-01T00:00:00Zhttps://doi.org/10.1186/s13018-021-02840-5https://doaj.org/toc/1749-799XAbstract Background Heterotopic ossification (HO) is a common complication after cervical disc replacement (CDR). Biomechanical factors including endplate coverage and intervertebral disc height change may be related to HO formation. However, there is a dearth of quantitative analysis for endplate coverage, intervertebral height change and their combined effects on HO. Methods Patients who underwent single-level or two-level CDR with Prestige-LP were retrospectively reviewed. Clinical outcomes were evaluated through Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, and visual analogue scale (VAS) score. Radiological data, including the prosthesis-endplate depth ratio, intervertebral height change, posterior heterotopic ossification (PHO) and angular parameters, were collected. Logistic regression analysis was used to identify the potential risk factors. Receiver operating characteristic curves were plotted and the cut-off values of each potential factors were calculated. Results A total of 138 patients with 174 surgical segments were evaluated. Both the prosthesis-endplate depth ratio (P < 0.001) and post-operative disc height change (P < 0.001) were predictive factors for PHO formation. The area under the curve (AUC) of the prosthesis-endplate depth ratio, disc height change and their combined effects represented by the combined parameter (CP) were 0.728, 0.712 and 0.793, respectively. The risk of PHO significantly increased when the prosthesis-endplate depth ratio < 93.77% (P < 0.001, OR = 6.909, 95% CI 3.521–13.557), the intervertebral height change ≥ 1.8 mm (P < 0.001, OR = 5.303, 95% CI 2.592–10.849), or the CP representing the combined effect < 84.88 (P < 0.001, OR = 10.879, 95% CI 5.142–23.019). Conclusions Inadequate endplate coverage and excessive change of intervertebral height are both potential risk factors for the PHO after CDR. Endplate coverage less than 93.8% or intervertebral height change more than 1.8 mm would increase the risk of PHO. The combination of these two factors may exacerbate the non-uniform distribution of stress in the bone-implant interface and promote HO development.Yi-Wei ShenYi YangHao LiuXin RongChen DingYang MengBei-Yu WangYing HongBMCarticleCervical disc replacementHeterotopic ossificationEndplate coverageIntervertebral height changeOrthopedic surgeryRD701-811Diseases of the musculoskeletal systemRC925-935ENJournal of Orthopaedic Surgery and Research, Vol 16, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cervical disc replacement Heterotopic ossification Endplate coverage Intervertebral height change Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935
spellingShingle	Cervical disc replacement Heterotopic ossification Endplate coverage Intervertebral height change Orthopedic surgery RD701-811 Diseases of the musculoskeletal system RC925-935 Yi-Wei Shen Yi Yang Hao Liu Xin Rong Chen Ding Yang Meng Bei-Yu Wang Ying Hong Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement
description	Abstract Background Heterotopic ossification (HO) is a common complication after cervical disc replacement (CDR). Biomechanical factors including endplate coverage and intervertebral disc height change may be related to HO formation. However, there is a dearth of quantitative analysis for endplate coverage, intervertebral height change and their combined effects on HO. Methods Patients who underwent single-level or two-level CDR with Prestige-LP were retrospectively reviewed. Clinical outcomes were evaluated through Japanese Orthopaedic Association (JOA) score, Neck Disability Index (NDI) score, and visual analogue scale (VAS) score. Radiological data, including the prosthesis-endplate depth ratio, intervertebral height change, posterior heterotopic ossification (PHO) and angular parameters, were collected. Logistic regression analysis was used to identify the potential risk factors. Receiver operating characteristic curves were plotted and the cut-off values of each potential factors were calculated. Results A total of 138 patients with 174 surgical segments were evaluated. Both the prosthesis-endplate depth ratio (P < 0.001) and post-operative disc height change (P < 0.001) were predictive factors for PHO formation. The area under the curve (AUC) of the prosthesis-endplate depth ratio, disc height change and their combined effects represented by the combined parameter (CP) were 0.728, 0.712 and 0.793, respectively. The risk of PHO significantly increased when the prosthesis-endplate depth ratio < 93.77% (P < 0.001, OR = 6.909, 95% CI 3.521–13.557), the intervertebral height change ≥ 1.8 mm (P < 0.001, OR = 5.303, 95% CI 2.592–10.849), or the CP representing the combined effect < 84.88 (P < 0.001, OR = 10.879, 95% CI 5.142–23.019). Conclusions Inadequate endplate coverage and excessive change of intervertebral height are both potential risk factors for the PHO after CDR. Endplate coverage less than 93.8% or intervertebral height change more than 1.8 mm would increase the risk of PHO. The combination of these two factors may exacerbate the non-uniform distribution of stress in the bone-implant interface and promote HO development.
format	article
author	Yi-Wei Shen Yi Yang Hao Liu Xin Rong Chen Ding Yang Meng Bei-Yu Wang Ying Hong
author_facet	Yi-Wei Shen Yi Yang Hao Liu Xin Rong Chen Ding Yang Meng Bei-Yu Wang Ying Hong
author_sort	Yi-Wei Shen
title	Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement
title_short	Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement
title_full	Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement
title_fullStr	Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement
title_full_unstemmed	Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement
title_sort	effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement
publisher	BMC
publishDate	2021
url	https://doaj.org/article/14164e02e9434e6794f1034b5217d61d
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_version_	1718407936546439168

Effects of endplate coverage and intervertebral height change on heterotopic ossification following cervical disc replacement

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