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Neck News

Ossification Is Not a Problem After Disc Replacement

Total disc replacement (TDR) for the cervical (neck) or lumbar spine are now available and in use. Bone growth around the implant that turns soft tissue (especially muscle) into bone is called heterotopic ossification (HO). The effect of this type of ossification is unknown. It may cause a loss of spinal motion or it may have no effect at all.

This is the first study to report on the effects of heterotopic bone after TDR. The authors report how often it occurs and compare motion between patients with and without this condition.

Serial X-rays taken before and after the TDRs were implanted in 276 patients. The X-rays showed both the condition of the bone and motion in the spine. Flexion, side bending, and extension motions were measured and analyzed. Everyone received the same Charité artificial disc. Follow-up was carried out over a two year period.

Results for patients with HO were compared to results for patients who didn't have HO. Pain levels and motion were not different between the two groups. About four per cent of the patients developed HO. In every case, it was a mild to moderate amount of bone formatin. X-rays showed that HO appeared between six and 12 weeks. It did not appear to change or get worse over time.

The authors suspect this low rate of HO is because there isn't much trauma to the muscles during the TDR operation. Rates of HO are much higher for operations like total hip replacement where muscles are cut during the procedure. No cutting or splitting of muscles is required during TDR.It was also suggested that patient function is not altered unless the HO is severe.


P. Justin Tortolani, MD, et al. Prevalence of Heterotopic Ossification Following Total Disc Replacement. In The Journal of Bone and Joint Surgery. January 2007. Vol. 89-A. No. 1. Pp. 82-88.

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