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Open Access 01-07-2016 | Original Article

Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)

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

Published in: European Spine Journal | Issue 7/2016

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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.

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Title: Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)
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
Publication date: 01-07-2016
Publisher: Springer Berlin Heidelberg
Published in: European Spine Journal / Issue 7/2016
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI: https://doi.org/10.1007/s00586-016-4549-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Heterotopic ossification and clinical outcome in nonconstrained cervical arthroplasty 2 years after surgery: the Norwegian Cervical Arthroplasty Trial (NORCAT)

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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