Radiological follow-up after implanting cervical disc prosthesis in anterior discectomy: a systematic review. 18 (2018) 1678-1693 by Yang, et al.

      Yang et al. in a recent issue of The Spine Journal presented an extensive, comprehensive, and long-overdue literature review and follow-up of patients who had undergone placement of a cervical prosthesis associated with anterior discectomy. This appears to be the first such paper to address heterotopic ossification (HO) in these patients and how this should be factored in when evaluating patients’ postoperative symptom relief and adjacent level degeneration. They conclude that “although scarce and of very low evidence, it seems that HO occurs on average in 10% of cases (a very crude estimate)”. They point out that only 7 studies addressed bridging bone (using grade 4 in the McAfee classification) but that all grades of HO range from 17.8% to 94.1% using other classifications. They conclude that radiologically, no firm conclusion can be drawn that implanting a prosthesis is superior to performing a fusion.
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