Title |
Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)
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Published in |
European Spine Journal, April 2016
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DOI | 10.1007/s00586-016-4549-6 |
Pubmed ID | |
Authors |
Jarle Sundseth, Eva Astrid Jacobsen, Frode Kolstad, Ruth O. Sletteberg, Oystein P. Nygaard, Lars Gunnar Johnsen, Are Hugo Pripp, Hege Andresen, Oddrun Anita Fredriksli, Erling Myrseth, John A. Zwart |
Abstract |
Heterotopic ossification is a phenomenon in cervical arthroplasty. Previous reports have mainly focused on various semiconstrained devices and only a few publications have focused on ossification around devices that are nonconstrained. The purpose of this study was to assess the occurrence of heterotopic ossification around a nonconstrained cervical device and how it affects clinical outcome 2 years after surgery. Thirty-seven patients were included from a larger cohort of a randomized controlled trial (NORCAT) which compared single-level cervical arthroplasty with fusion. The occurrence of heterotopic ossification was assessed with a CT scan and two neuroradiologists determined its degree. For grading, we used the Mehren/Suchomel classification system (grade 0-4). The patients were divided by level of ossification, low grade (0-2) or high grade (3-4), and clinical outcomes were compared. Self-rated disability for neck and arm pain (Neck Disability Index), health-related quality of life (the Short Form-36 and EuroQol-5D), and pain (the Numeric Rating Scale 11) were used as clinical outcome measures. Heterotopic ossification was encountered in all patients 2 years after surgery. Complete fusion (grade 4) was found in 16 % of participants, and high-grade ossification (grade 3-4) occurred in 62 %. The remaining patients were classified as having low-grade ossification (grade 2). There were no differences in the clinical outcomes of patients with low- and high-grade ossification. High-grade heterotopic ossification and spontaneous fusion 2 years after surgery were seen in a significant number of patients. However, the degree of ossification did not influence the clinical outcome. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Norway | 1 | 50% |
Unknown | 1 | 50% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 2 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 46 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Bachelor | 6 | 13% |
Other | 6 | 13% |
Researcher | 6 | 13% |
Student > Master | 5 | 11% |
Student > Ph. D. Student | 5 | 11% |
Other | 5 | 11% |
Unknown | 13 | 28% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 21 | 46% |
Nursing and Health Professions | 4 | 9% |
Social Sciences | 2 | 4% |
Arts and Humanities | 1 | 2% |
Unspecified | 1 | 2% |
Other | 2 | 4% |
Unknown | 15 | 33% |