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Title: | The changes in cervical biomechanics after CTDR and its association with heterotopic ossification : a systematic review and meta-analysis | Authors: | Hui, NH Phan, K Lee, MY Kerferd, J Singh, T Mobbs, RJ |
Issue Date: | May-2021 | Source: | Global spine journal, May 2021, v. 11, no. 4, p. 565-574 | Abstract: | Study Design: A systematic review and meta-analysis. Objectives: Cervical total disc replacement (CTDR) can preserve range of motion (ROM) of the operated spinal segment in cadaver studies. Evidence is less clear in clinical trials. The present study aims to investigate the differences in cervical biomechanics before and after CTDR and its association with heterotopic ossification (HO) development. Method: Articles that reported the rate of HO and >= 1 difference in cervical biomechanics were included in quantitative analyses. We pooled the mean difference (MD) of cervical biomechanics before and after CTDR. Subgroup analyses and metaregression analyses were conducted to identify potential contributors to heterogeneity. Results: Of the 599 studies screened, 35 studies were included in the final analysis. In comparison with preoperative values, ROM of the spinal segment inferior (MD: 0.38; 95% CI: 0.02 to 0.74) and superior (MD: 0.43; 95% CI: 0.12 to 0.75) to the surgical spinal segment, functional spinal unit (FSU) angle (MD: 2.23; 95% CI: 1.11 to 3.35), and C2/C7 Cobb angle (MD: 3.49; 95% CI: 1.73 to 5.25) significantly increased after CTDR. In contrast, FSU and cervical ROM at baseline were no different from follow-up. On multivariable meta-regression analyses, HO and ROM-limiting HO were not associated with changes in cervical biomechanics. Single-level CTDR and duration of follow-up were associated with changes in cervical biomechanics. Conclusion: Our study reported the pooled mean of biomechanics at baseline and final follow-up and their differences. The changes in biomechanics were not associated with the rates of HO and ROM-limiting HO. |
Keywords: | Cervical spine Arthroplasty Biomechanics Heterotopic ossification |
Publisher: | SAGE Publications | Journal: | Global spine journal | ISSN: | 2192-5682 | EISSN: | 2192-5690 | DOI: | 10.1177/2192568220922949 | Rights: | © 2021 THE AUTHORS. Published by Elsevier BV on behalf of Faculty of Engineering, Ain Shams University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). The following publication Hui N, Phan K, Lee M-Y, Kerferd J, Singh T, Mobbs RJ. The Changes in Cervical Biomechanics After CTDR and Its Association With Heterotopic Ossification: A Systematic Review and Meta-analysis. Global Spine Journal. 2021;11(4):565-574 is available at https://dx.doi.org/10.1177/2192568220922949 |
Appears in Collections: | Journal/Magazine Article |
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