title: Heterotopic ossification in cervical disc arthroplasty: Is it clinically relevant?
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  To analyze the presence and clinical relevance of heterotopic ossification (HO) at 3 years mean follow-up.
  
  
  METHODS
  Thirty patients suffering from cervical radiculopathy and/or myelopathy treated with anterior disc replacement (ADR) were studied. HO was classified using the McAfee grading system. Range of motion was measured from flexion and extension x-rays. Short-form 36 and neck disability index (NDI) assessed functional outcome.
  
  
  RESULTS
  Forty-five prostheses were implanted in 30 patients with cervical radiculopathy and/or myelopathy, mean age 40.9 years. Nineteen patients received 1 level and 11 patients received multilevel disc replacement. The incidence rate of HO was 42.2% (19 levels). Segmental range of motion was ≥3° in 93.8% of patients with HO. There was no significant difference in functional scores between those who did and those who did not develop HO. Males tended to develop HO more frequently than females, though this was not statistically significant. The indication for surgery (soft disc hernia or spondylosis) was not associated with the formation of HO.
  
  
  CONCLUSIONS
  Functional improvement is maintained despite the presence of HO following cervical disc arthroplasty. Indications for arthroplasty should not be halted by the risk of HO. [Table: see text] The definiton of the different classes of evidence is available on page 83.
authors.affiliation: Department of Neurosurgery, Azienda Ospedaliero-Universitaria "Policlinico-Vittorio Emanuele", Catania, Italy.
authors.forename: Giuseppe M
authors.initials: GM
authors.lastname: Barbagallo
authors.forename: Leonardo A
authors.initials: LA
authors.lastname: Corbino
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Olindo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Albanese
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