The London Spine Unit : top day surgery hospital in UKPublished articleObjective: To investigate parameters related to quantifying the amount of degeneration in preoperative patients to identify ideal indication of artificial cervical disc replacement (ACDR) in patient with a minimum of 10 years of follow-up data. Methods: From January 2004 to August 2008, a total of 44 patients underwent single level Bryan cervical disk replacement performed by the same group of surgeons were involved in this retrospective study, and all of the patients in this group had at least…Cervical Disc Replacement Expert. Best Spinal Surgeon UKThe London Spine Unit is a specialist clinic for Cervical Disc Replacement as Day Surgery.
To investigate parameters related to quantifying the amount of degeneration in preoperative patients to identify ideal indication of artificial cervical disc replacement
(ACDR) in patient with a minimum of 10 years of follow-up data. Methods:
From January 2004 to August 2008, a total of 44 patients underwent single level Bryan cervical disk replacement performed by the same group of surgeons were involved in this retrospective study, and all of the patients in this group had at least 10 years of follow-up data. Heterotopic ossification (HO) was graded in radiographic images by using the McAfee classification. Preoperative degeneration of cervical spine was evaluated in radiographs based on a quantitative”9 points”scoring system. Univariate analysis and multifactor logistic regression were made to identify significant factors. To determine the cut-off points for the significant factors, a receiver operating characteristic (ROC) curve analysis was conducted. Results:
The incidence of HO in study group was 61.4%. Based on univariate analysis results, there were significant differences in the scores of disc height, the presence of anterior osteophytes and endplate sclerosis between the HO group and non-HO group (all P
<0.05), and the indices were included in the multivariate analysis. According to the logistic regression results, disc height and endplate sclerosis were identified as the independent risk factors for HO(OR
): 10.801(1.202-97.064), 37.870(1.581-907.237), respectively, both P
<0.05). ROC analysis showed the area under the curve (AUC) of disc height and endplate sclerosis were 0.822 and 0.792, respectively. According to the scoring system, the ROC curve indicated that both the optimal cutoff points were 1.5.
The incidence of postoperative HO is relatively high among the patients who had more than 10 years follow-up, and the amount of degeneration in the target level before surgery correlated with the incidence of HO.
Pass 10 The follow-up data for more than one year was used to analyze the factors and reference values related to the indication selection of patients before Bryan artificial cervical disc replacement
Retrospective analysis 2004 January to 2008 August, Peking University Third Hospital, the same group of doctors used single-segment Bryan cervical artificial disc Data of 44 patients undergoing replacement surgery. All patients included in the study have 10 follow-up for more than years . In imaging, McAfee classification was used to evaluate the formation of postoperative heterotopic ossification (HO); the “9-point method” cervical spine degeneration scoring system was used to evaluate the degree of degeneration of the preoperative surgical segment on cervical spine X-rays. Through univariate analysis and multivariate logistic regression analysis, statistically significant indicators were determined. Further use receiver operating characteristic (ROC) curve and area under the curve (AUC) to determine the quantitative reference value. Results:
The overall incidence of postoperative HO in patients was 61.4%(27/44 ). Univariate analysis showed that there were statistically significant differences in the height loss of the operative segment intervertebral space, the formation of anterior vertebral body osteophytes, and endplate sclerosis between the HO-affected group and the HO-unaffected group (both P
<0.05), and logistic regression analysis found that the height of the intervertebral space and endplate sclerosis before surgery are independent risk factors for the formation of postoperative HO [OR
) is 10.801 (1.202~97.064), 37.870(1.581~907.237), both P
<0 .05], ROC curve analysis, two The AUC of the person is 0.822 and 0.792, based on the "9 points method", the boundary value of both is 1.5.
The incidence of HO after Bryan cervical artificial disc replacement
is relatively high, and the preoperative surgical segment degeneration Degree is the key factor in its occurrence. .