Incidence of bone loss after Prestige-LP cervical disc arthroplasty: a single-center retrospective study of 396 cases
Incidence of bone loss after Prestige-LP cervical disc arthroplasty: a single-center retrospective study of 396 cases
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Prestige-LP颈椎间盘置换术后骨丢失发生率：396例单中心回顾性研究
DOI：
10.1016/j.spinee.2020.05.102
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发表时间：
2020-08-01
期刊：
影响因子：
4.5
通讯作者：
Hong, Ying
中科院分区：
文献类型：
--
作者：
Wu, Ting-kui;Liu, Hao;Hong, Ying
背景：颈椎间盘置换术（CDA）后手术节段骨丢失（BL）的发展尚未得到充分认识。BL的发生率可能与假体类型有关。目前，没有研究报道Prestige-LP椎间盘CDA后BL的发生率，这仍然是一个活跃的研究领域。目的：确定Prestige-LP CDA后BL的发生率，并评估BL对临床和影像学结果的影响。研究设计：这是一项观察性研究。患者样本：共396例患者进行了审查。结局指标：评价日本骨科协会（乔亚）、视觉疼痛量表（VAS）和颈部残疾指数（NDI）评分。测量颈椎前凸、椎间盘角度、整体和节段活动度（ROM）、异位骨化（HO）和BL。方法：我们回顾性分析了2008年1月至2018年10月在我们机构接受Prestige-LP椎间盘手术的患者。使用乔亚、VAS和NDI评分评价临床结局。影像学变量，包括颈椎前凸，椎间盘角度，整体和节段ROM，HO和BL，retrieved.Results：共396例患者和483个CDA进行了评价。BL发生在56.6%的患者和52.8%的CDA节段。CDA节段中轻度BL发生率为30.2%，中度BL发生率为37.3%，重度BL发生率为32.5%。值得注意的是，88.2%的CDA节段在前3个月内发生BL，其中19.1%在6个月时进展。然而，12个月后未观察到进行性BL。约50.2%的CDAs表现为上级和低级终板受累。BL的发生与年龄、手术类型、节段分布、HO的发生率和分级有关。BL患者有一个更好的节段性ROM，但没有关系的患者或没有BL被发现在临床outcomes.Conclusions：BL是一种常见的，但自限性的现象后，CDA在术后早期。多发生于相对年轻的患者、双节段CDA和C5/6节段。然而，BL患者的临床结局没有恶化，关节置换节段的运动保留更出色，HO等级较低的发生率较低。(c)2020爱思唯尔公司All rights reserved.
BACKGROUND CONTEXT: The development of bone loss (BL) at the operated level after cervical disc arthroplasty (CDA) has not been well recognized. The incidence of BL may be correlated with the prosthesis type. Currently, no study has reported the incidence of BL after CDA with the Prestige-LP disc, and this remains an active area of research.PURPOSE: To determine the incidence of BL after Prestige-LP CDA and evaluate the impact of BL on clinical and radiological outcomes.STUDY DESIGN: This is an observational study.PATIENT SAMPLE: A total of 396 patients were reviewed.OUTCOME MEASURES: The Japanese Orthopedics Association (JOA), Visual Analogue Scale (VAS), and Neck Disability Index (NDI) scores were evaluated. Cervical lordosis, disc angle, global and segmental range of motion (ROM), heterotopic ossification (HO), and BL were measured.METHODS: We retrospectively reviewed patients who underwent Prestige-LP disc from January 2008 to October 2018 at our institution. Clinical outcomes were evaluated using JOA, VAS, and NDI scores. Radiological variables, including cervical lordosis, disc angle, global and segmental ROM, HO, and BL, were retrieved.RESULTS: A total of 396 patients and 483 CDAs were evaluated. BL occurred in 56.6% of patients and 52.8% of CDA segments. Mild BL occurred in 30.2%, moderate BL in 37.3%, and severe BL in 32.5% of CDA segments. Notably, 88.2% of CDA segments developed BL within the first 3 months, and 19.1% of them progressed at 6 months. However, no progressive BL after 12 months was seen. About 50.2% of CDAs showed superior and inferior endplates involvement. The incidence of BL was associated with age, surgery type, level distribution, and incidence and grade of HO. Patients with BL had a better segmental ROM, but no relationships between patients with or without BL were found in clinical outcomes.CONCLUSIONS: BL was a common but self-limited phenomenon after CDA at the early postoperative stage. It occurred more often in relatively young age patients, two-level CDA, and C5/6 segment. However, patients suffering from BL showed no deterioration of the clinical outcomes, more exceptional motion preservation at the arthroplasty level, and lower incidence with a lower grade of HO. (c) 2020 Elsevier Inc. All rights reserved.