Bryan Cervical Intervertebral Disc Arthroplasty After Heterotopic Ossification Of Clinical Research

Anterior cervical discectomy and fusion (ACDF) is a classic surgical treatment of cervical spondylosis, but the accelerate adjacent segment degeneration caused the reflection of people; Cervical artificial disc replacement (ACDR) can relieve symptoms of nerve compression, while retaining the rang of motion to avoid or reduce the incidence adjacent vertebral disease, more and more people of all ages. But with the new technology in depth, postoperative complications attract people’s attention, which heterotopic ossification became the focus of attention. The prosthesis replacement can avoid the complications, however, heterotopic ossification contrary to this concept, if it can not effectively prevent heterotopic ossification occurred, we will lose the artificial prosthesis replacement of significance.This paper reviews some of the major introduced heterotopic ossification of the status quo, including the definition, etiology and pathology, pathogenesis, clinical manifestations, and diagnosis and treatment Prevention, a brief introduction in the medical understanding of heterotopic ossification in focus from preoperative surgeryaf ter analysis and other aspects of the impact of the factors of cervical artificial disc replacement heterotopic ossification after. The clinical research component is to collect clinical data for the past two years in our department simplex Bryan artificial cervical disc replacement surgery a retrospective study.Objective:Retrospective analysis the recent postoperative incidence of heterotopic ossification, correlation analysis and the influencing factors of heterotopic ossification, heterotopic ossification on the activity of the lesion segments.Methods:The clinical data are from the Orthopaedic Center of Dongzhimen Hospital which purely artificial cervical disc replacement surgery patients from January2011to December2012, a total of37cases, all met the inclusion criteria. There were17males and20females, aged34to68years old, with an average of51.41years of age, nerve root type cervical spondylosis21cases,8cases of cervical spondylotic myelopathy,8cases of mixed cervical spondylosis, single segmental replacement27cases, double segment replacement10cases, C3/4for the three segments, C4/5to18segments, C5/6to24sections, C6/7for the two segments, the segment of28female,19male segments, a total of47segments;≤50years13cases,17segments,50years old,24cases,30segments. All Surgeries are by the same surgeon. One day perspective after cervical spine lateral radiographs to observe the position of the prosthesis, two weeks, one month, two months, three months, six months, one year, two years outpatient review cervical positive side flexion and extension of four X-ray postoperative ectopic ossification occurs through lateral radiographs according to McAfee classification assessment by flexion hyperextended piece measuring the activity of the rang motion (ROM), and preoperative control. This group of patients after surgery to be greater than the3-month fol low-up, of which a maximum of20months, with an average of8.81months. Application SPSS17.0software for statistical analysis of relevant information.Results:37patients with47segments, which after six segments occurred HO, incidence of12.77%, the majority in the4to8weeks after surgery, degree of heterotopic ossification the McAfee classification method Ⅰ level1cases; Ⅱ level, five cases, follow-up of patients not found inter-body fusion. Clinical data at different basis divided into a number of the control group from a gender distinction between men three segments, the rate was15.79%, the three segments of the women, the incidence rate of10.71%, p＞0.05, the difference was not statistically significant. Limit of50years old, divided into old age group (24cases,30segments) and the younger age group (13patients,17segments), its HO high incidence and younger age group were0.00%and20.00%, p＜0.05, a statistically significant difference. Single segment was significantly lower than the incidence of double segment, but P＞0.05, not statistically significant, the number of segments. From view cervical typing, nerve root type,21cases,3cases of myelopathy eight cases occurred in1patient, mixed in8cases occurred two cases of HO occurrence rate of14.29%,12.50%,25.00%; P＞0.05, not statistically significant. Related survey from the operative time and blood loss, mean operative time of HO106.83min, blood loss25.67ml, The average operative time of HO was86.10min, blood loss16.13ml, Logistic regression analysis of both the correlation analysis and the occurrence of ectopic ossification, operation time, P=0.042, p＜0.05, statistically significant; blood loss, P=0.067, P＞0.05, not statistically significant. From the underlying disease, the analysis of cardiopulmonary cerebral disease and ectopic ossification formation of the joint class correlation, P＞0.05, not statistically significant. Activity from the activity of the last follow-up segment lesions and preoperative, P＞0.05, the difference was not statistically significant.Conclusion:The results of this study show that the the heterotopic ossification incidence of simple Bryan artificial cervical disc replacement surgery in the near future low correlation with age and operative time, but the follow-up found that the occurrence of heterotopic ossification in patients with segmental lesions was no significant difference in the activity with preoperative recent terms, HO formation had no significant effect on the postoperative effects of artificial cervical disc replacement technology is an effective method for the treatment of degenerative cervical spondylosis. The above conclusions need further long-term clinical validation of large sample.