THE INFLUENCE OF HETEROTOPIC OSSIFICATION ON CLINICAL AND RADIOLOGICAL OUTCOMES AFTER TOTAL LUMBAR DISC REPLACEMENT WITH M6-L PROSTHESIS: A MULTICENTER STUDY
https://doi.org/10.14531/ss2017.4.69-75
Abstract
Objective. To assess the degree of influence of heterotopic ossification on the motion amplitude of the operated segment and on clinical outcomes in patients after total intervertebral disc replacement.
Material and Methods. Results of total replacement of the intervertebral disc with the M6-L prosthesis were analyzed in 74 patients aged 23–45 years. Follow-up period was 36 months. The motion amplitude of operated segments and the degree of heterotopic ossification were estimated. Clinical outcomes were analyzed based on pain syndrome severity according to the VAS and on the level of the back pain-related quality of life according to the Oswestry index.
Results. Signs of heterotopic ossification were found in 27 (36.4%) patients: Grade I – in 11 (14.8 %), Grade II – in 14 (18.9 %), and Grade III – in 2 (2.7 %). The mean values of the motion amplitude of operated segments, VAS score and Oswestry index in the group of patients without signs of heterotopic ossification were 11.2° ± 2.7°, 2.8 ± 1.2 cm and 17.3 ± 6.5 %, respectively, and those in the group of patients with signs of heterotopic ossification – 11.5° ± 1.2°, 3.4 ± 1.8 cm and 19.8 ± 7.3 %, respectively.
Conclusion. Heterotopic ossification following total lumbar disc replacement occurs in 36.4 % of cases. High grade of heterotopic ossification reliably affects the amplitude of segment motion, though there was no significant influence on clinical results in patients.
About the Authors
Vadim A. ByvaltsevRussian Federation
DMSc, Chief neurosurgeon of the Health Department of JSCo «Russian Railways», head of the Centre of Neurosurgery, Road Clinical Hospital at «Irkutsk-Passazhirskiy» station of JSCo «Russian Railways», director of the course of neurosurgery, Irkutsk State Medical University, head of scientificclinical department of neurosurgery of the Irkutsk Scientific Centre of Surgery and Traumatology, Professor of the Department of Traumatology, Orthopaedics and Neurosurgery of Irkutsk State Medical Academy of Continuing Education
Yury Ya. Pestrjakov
Russian Federation
post-graduate student in neurosurgery, Irkutsk State Medical University, Irkutsk; highest category neurosurgeon, Head of Neurosurgical Department, Krasnoyarsk Regional Hospital
Valery V. Shepelev
Russian Federation
Neurosurgeon-in-Chief of Navy Pacific Fleet RF, Head of Neurosurgical Unit of 1477 Naval Clinical Hospital, Vladivostok; postgraduate student in neurosurgery, Irkutsk State Medical University
Ivan A. Stepanov
Russian Federation
postgraduate student, Irkutsk State Medical University
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Review
For citations:
Byvaltsev V.A., Pestrjakov Yu.Ya., Shepelev V.V., Stepanov I.A. THE INFLUENCE OF HETEROTOPIC OSSIFICATION ON CLINICAL AND RADIOLOGICAL OUTCOMES AFTER TOTAL LUMBAR DISC REPLACEMENT WITH M6-L PROSTHESIS: A MULTICENTER STUDY. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2017;14(4):69-75. https://doi.org/10.14531/ss2017.4.69-75