Medical School, College of Medicine and Health, University of Exeter, Exeter, UK.
Department of Engineering, University of Exeter, Exeter, UK.
BMC Musculoskelet Disord. 2022 Apr 23;23(1):382. doi: 10.1186/s12891-022-05322-9.
Lumbar total disc replacement (TDR) is an alternative to lumbar fusion in the treatment of lower back pain and reduces the risk of adjacent segment degeneration. Heterotopic ossification (HO) has been identified as a common complication following lumbar TDR.
This systematic review aims to determine the prevalence, risk factors and clinical and radiological impact of HO following lumbar TDR.
Systematic Review.
MEDLINE, Scopus, PubMed and Cochrane Central were searched for articles that referred to lumbar TDR and HO. The hits were assessed against inclusion and exclusion criteria. Data from each included study was extracted and analysed with respect to the study aims.
Twenty-six studies were included in this review and the pooled prevalence of HO was estimated to be between 13.2% (participants) and 15.3% (vertebral levels). TDR clinical outcomes were not found to be reduced by HO and there was insufficient data to identify a given impact upon radiological outcomes. Age and follow up time were identified as potential risk factors for HO.
This review was hampered by inconsistencies in the reporting of HO across the studies. We therefore recommend that a set of guidelines should be produced to aid future researchers and reduce the risk of bias.
腰椎全椎间盘置换术（TDR）是治疗下腰痛的一种替代腰椎融合术的方法，可以降低邻近节段退变的风险。异位骨化（HO）已被确定为腰椎 TDR 后的常见并发症。
本系统评价旨在确定腰椎 TDR 后 HO 的发生率、危险因素以及对临床和影像学的影响。
系统评价。
在 MEDLINE、Scopus、PubMed 和 Cochrane Central 中搜索了涉及腰椎 TDR 和 HO 的文章。根据纳入和排除标准对这些文章进行评估。从每篇纳入的研究中提取数据，并根据研究目的进行分析。
本综述共纳入了 26 项研究，HO 的总体发生率估计在 13.2%（参与者）至 15.3%（椎体水平）之间。HO 并未降低 TDR 的临床疗效，并且没有足够的数据确定其对影像学结果的特定影响。年龄和随访时间被确定为 HO 的潜在危险因素。
本综述受到各研究之间 HO 报告不一致的限制。因此，我们建议制定一套指南，以帮助未来的研究人员并降低偏倚风险。
