He Junbo, Liu Hao, Wu Tingkui, Ding Chen, Huang Kangkang, Hong Ying, Wang Beiyu
Department of Orthopedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Rd, Chengdu, 610041, China.
BMC Musculoskelet Disord. 2020 Oct 8;21(1):664. doi: 10.1186/s12891-020-03664-w.
Hybrid surgery (HS) has become an alternative procedure for the treatment of multilevel cervical degenerative disc disease with satisfactory outcomes. However, some adverse outcomes have recently emerged, such as heterotopic ossification (HO) and anterior bone loss (ABL). Furthermore, HO was found mostly located in the posterior and lateral of the cervical intervertebral disc space. The mechanism of anterior heterotopic ossification (AHO) formation may be different, and its relationship with ABL was uncertain.
Radiographical and clinical outcomes of ninety-seven patients who had undergone contiguous two-level HS between December 2010 and December 2017 and with a minimum of 2-year follow-up were analyzed. Postoperative radiographs were evaluated and compared to the initial postoperative films to determine the incidence of ABL and AHO.
The overall incidence rate of ABL was 44.3% (43/97). It was identified in 70.6% of AHO cases (33.3% mild, 41.7% moderate, 25.0% severe) and 38.8% of non-AHO cases (38.7% mild, 45.2% moderate, 16.1% severe). A significant association between ABL and AHO occurrence was found (P = 0.016). There was no significant difference in prosthesis-endplate depth ratio or disc space angle change between the AHO group and the non-AHO group (P > 0.05). Compared with data preoperatively, clinical outcome scores significantly improved after surgery in both the AHO and non-AHO groups, with no significant differences between the two groups (P > 0.05).
ABL was common in HS, and it related to AHO. The formation of AHO could be an integral part of postoperative bone remodeling, as well as ABL.
杂交手术（HS）已成为治疗多节段颈椎退行性椎间盘疾病的一种替代手术，效果令人满意。然而，最近出现了一些不良后果，如异位骨化（HO）和前路骨质丢失（ABL）。此外，发现HO大多位于颈椎椎间盘间隙的后部和外侧。前路异位骨化（AHO）形成的机制可能不同，其与ABL的关系尚不确定。
分析了2010年12月至2017年12月期间接受连续两节段HS且至少随访2年的97例患者的影像学和临床结果。对术后X线片进行评估，并与术后初始片进行比较，以确定ABL和AHO的发生率。
ABL的总体发生率为44.3%（43/97）。在70.6%的AHO病例中发现了ABL（轻度33.3%，中度41.7%，重度25.0%），在38.8%的非AHO病例中发现了ABL（轻度38.7%，中度45.2%，重度16.1%）。发现ABL与AHO的发生之间存在显著关联（P = 0.016）。AHO组和非AHO组之间的假体-终板深度比或椎间盘间隙角度变化无显著差异（P > 0.05）。与术前数据相比，AHO组和非AHO组术后临床结果评分均显著改善，两组之间无显著差异（P > 0.05）。
ABL在HS中很常见，且与AHO有关。AHO的形成可能是术后骨重塑的一个组成部分，ABL也是如此。
Zotero 插件
