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The Residual Exposed Endplate Ratio Is Predictive Of Posterior Heterotopic Ossification After Cervical Bryan Disc Arthroplasty – Cervical Disc Replacement

This article discusses the relationship between the residual exposed endplate (REE) ratio and the development of posterior heterotopic ossification (HO) after disc arthroplasty. The study included adult patients who underwent Bryan cervical disc arthroplasty (CDA) and were followed up for at least two years. The results showed that a REE ratio >9% was a predictor for the formation of posterior HO. The study concludes that the REE is highly correlated with the development of posterior HO after Bryan CDA, regardless of the level of implantation, and an undersized implant causing a REE ratio >9% is a predictor of postoperative posterior HO formation

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised spinal centre in the world

Published article

CONCLUSIONS: REE is highly correlated with the development of postoperative posterior HO after Bryan CDA, regardless of the level of implantation. An undersized implant causing a REE ratio >9 % is a predictor of postoperative posterior HO formation after cervical Bryan CDA.

Cervical Disc Arthroplasty Surgery Expert. Best Spinal Surgeon UK
Abstract Objectives: Heterotopic ossification (HO), a major cause of dysfunction after disc arthroplasty (CDA). The aim of this study was to determine the cut value of the residual exposed endplate (REE) ratio and to predict the development of posterior HO after Bryan CDA. Methods: This retrospective study investigated the relationship between the REE ratio and,

Abstract

Objectives: Heterotopic ossification (HO), a major cause of dysfunction after disc arthroplasty (CDA). The aim of this study was to determine the cut value of the residual exposed endplate (REE) ratio and to predict the development of posterior HO after Bryan CDA.

Methods: This retrospective study investigated the relationship between the REE ratio and posterior HO formation after Bryan CDA. Consecutive adult patients who underwent 1- or 2-level Bryan CDA by a single neurosurgeon between 2006 and 2016 with at least two years follow-up were included. Postoperative radiographic analysis and measurement were performed to obtain the REE ratio and the HO grade.

Results: Of 249 patients with 384 surgical levels who underwent Bryan CDA during the study period, 114 (45.8 %) received 1-level CDA and 135 (54.2 %) received 2-level CDA. Lateral radiographs showed that 169 implants (44 %) had posterior HOs in all grades after two years or more of follow up and 14 implants (3.64 %) had severe HO (McAfee grades 3 and 4). In 329 implants (85.7 %), a comparison of radiographs to CT examination of HO grading showed a substantial relationship. Using area under the curve (AUC) analysis, a REE ratio >9 %, with 65.1 % sensitivity and 86.5 % specificity, was the cut point for posterior HO formation.

Conclusions: REE is highly correlated with the development of postoperative posterior HO after Bryan CDA, regardless of the level of implantation. An undersized implant causing a REE ratio >9 % is a predictor of postoperative posterior HO formation after cervical Bryan CDA.

Keywords: Bryan CDA; Cervical disc arthroplasty; Dysfunction; Heterotopic ossification; McAfee classification; Residual exposed endplate.

The London Spine Unit : best recognised spinal centre in the world

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The residual exposed endplate ratio is predictive of posterior heterotopic ossification after cervical Bryan disc arthroplasty

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Abstract Objectives: Heterotopic ossification (HO), a major cause of dysfunction after disc arthroplasty (CDA). The aim of this study was to determine the cut value of the residual exposed endplate (REE) ratio and to predict the development of posterior HO after Bryan CDA. Methods: This retrospective study investigated the relationship between the REE ratio and

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