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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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학술저널
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대한척추신경외과학회 Neurospine 대한척추신경외과학회지 제9권 제3호
발행연도
2012.1
수록면
209 - 214 (6page)

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Objective: To elucidate etiological factors of heterotopic ossification (HO) by evaluating retrospectively if HO is a unique finding following cervical total disc replacement (CTDR) or a finding observable following an anterior cervical interbody fusion (ACIF). Methods: The authors had selected 87 patients who underwent anterior cervical surgery (TDR or ACIF), and could be followed up more than 24 months. A cervical TDR was performed using a Bryan disc or a ProDisc-C and an ACIF using a standalone cage or fibular allograft with a plate and screws system. The presence of HO was determined by observing plain radiography at the last follow up. The relation between HO occurrence and specific preoperative radio- logical findings (osteophyte and calcification of posterior longitudinal ligament (PLL)) at the index level was investigated. Results: Cervical TDR was performed in 40 patients (43 levels) and ACIF in 47 patients (54 levels). At the final radiographs, HO was demonstrated at 27 levels (TDR-Bryan; 8/18, TDR-Prodisc-C; 12/25, ACIF-cage alone; 7/29, and ACIF-plate screw; 0/25). Mean ROM at the last follow-up of each TDR subgroup were 7.8±4.7° in Bryan, 3.89±1.77° in Prodisc-C, and it did not correlated with the incidence of HO. Fusion status of ACIF groups was observed as 2 case of grade 1, 6 of grade 2, and 21 of grade 3 in cage alone subgroup, and no case of grade 1, 4 of grade 2, and 21 of grade 3 in plate screw subgroup. Fusion status in ACIF-cage alone subgroup was significantly related to the HO incidence. The preoperative osteophyte at the operated level observed in 27 levels, and HO was demonstrated in 12 levels (TDR-Bryan; 3/5, TDR-Prodisc-C; 2/3, ACIFcage alone; 7/11, and ACIF-plate screw; 0/8). Preoperative PLL calcification at the operated level was observed 22 levels, and HO was defined at 14 levels (TDR-Bryan; 5/5, TDR-Prodisc-C; 4/5, ACIF-cage alone; 5/7, and ACIF-plate screw; 0/5). The evidence of preoperative osteophyte and PLL calcification showed statistically significant relations to the occurrence of HO. Conclusion: HO was observed in both TDR and ACIF groups. HO was more frequently occurred in TDR group regardless of prosthesis type. In ACIF group, only cage alone subgroup showed HO, with relation to fusion status. Preoperative calcification of longitudinal ligaments and osteophyte were strongly related to the occurrence of HO.
#Degenerative cervical spine disease #Cervical arthroplasty #Heterotopic ossification #Bryan disc #Prodisc-C #Cervical athrodesis

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참고문헌 (21)

참고문헌 신청
Ahrengart L / 1988 / Comparative study of the effects of radiation, indomethacin, prednisolone, and ethane-1- hydroxy-1, 1-diphosphonate (EHDP) in the prevention of ectopic bone formation / Clin Orthop Relat Res :265~273 google schola Balboni TA / 2006 / Heterotopic ossification: Pathophysiology, clinical features, and the role of radiotherapy for prophylaxis / Int J Radiat Oncol Biol Phys 65:1289~1299 google schola Brooker AF / 1973 / Ectopic ossification following total hip replacement. Incidence and a method of classification / J Bone Joint Surg Am 55:1629~1632 google schola Eggli S / 2001 / Risk factors for heterotopic ossification in total hip arthroplasty / Arch Orthop Trauma Surg 121:531~535 google schola Hannallah D / 2004 / Retroviral delivery of Noggin inhibits the formation of heterotopic ossification induced by BMP-4, demineralized bone matrix, and trauma in an animal model / J Bone Joint Surg Am 86-A:80~91 google schola

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