He Junbo, Chen Hua, Wu Tingkui, Rong Xin, Ding Chen, Wang Beiyu, Liu Hao
Department of Orthopedic Surgery, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, China.
Global Spine J. 2025 Mar;15(2):353-362. doi: 10.1177/21925682231190612. Epub 2023 Jul 17.
Retrospective case-control study.
To evaluate postoperative outcomes of single-level cervical disc arthroplasty (CDA) in patients with osteopenia and compare these results with a matched cohort of normal bone mineral density (BMD).
Patients who had undergone single-level CDA were collected and screened. Included patients were divided into the osteopenia group and the normal group. 38 eligible patients with osteopenia were included in the final analysis. Subsequently, a 1:1 match was utilized. Clinical, radiographic data, and complications were recorded. Appropriate statistical methods were applied to conduct analysis using SPSS version 24.0.
The mean follow-up time was 30.5 ± 27.3 months. The osteopenia group achieved satisfactory clinical outcomes, with no significant intergroup differences. Additionally, there were no significant differences between groups in any of the radiological parameters, either in cervical alignment or segmental height, or range of motion. The radiological incidence rate of adjacent segmental degeneration and heterotopic ossification (HO) was comparable in both groups, respectively, with a similar composition of ROM-limiting HO. However, the osteopenia group had a tendency of more implant subsidence (2.7% vs 15.2%). The logistic regression analysis showed the osteopenia group had a significantly higher incidence rate of anterior bone loss (ABL) (OR = 5.37, 95% CI: 1.50 - 19.22).
Single-level CDA for patients with osteopenia achieved similar satisfactory clinical outcomes compared with the normal BMD group. Meanwhile, the osteopenia group maintained adequate sagittal balance and segmental height. Based on this observation, this option may be feasible for selected patients with osteopenia.
回顾性病例对照研究。
评估骨质减少患者单节段颈椎间盘置换术（CDA）的术后结果，并将这些结果与骨密度正常的匹配队列进行比较。
收集并筛选接受单节段CDA的患者。纳入的患者分为骨质减少组和正常组。最终分析纳入了38例符合条件的骨质减少患者。随后，采用1:1匹配。记录临床、影像学数据和并发症。应用适当的统计方法，使用SPSS 24.0版进行分析。
平均随访时间为30.5±27.3个月。骨质减少组取得了满意的临床结果，组间无显著差异。此外，在颈椎排列、节段高度或活动范围等任何放射学参数方面，两组之间均无显著差异。两组相邻节段退变和异位骨化（HO）的放射学发生率相当，ROM限制型HO的组成相似。然而，骨质减少组有更多假体下沉的趋势（2.7%对15.2%）。逻辑回归分析显示，骨质减少组的前侧骨质流失（ABL）发生率显著更高（OR = 5.37，95%CI：1.50 - 19.22）。
与骨密度正常组相比，骨质减少患者的单节段CDA取得了相似的满意临床结果。同时，骨质减少组维持了足够的矢状面平衡和节段高度。基于这一观察结果，对于选定的骨质减少患者，这种选择可能是可行的。
