Severe heterotopic ossification in a seronegative spondyloarthritis patient after cervical Bryan disc arthroplasty: A case report  

作　　者：Chih-Wei Huang Chien-Lun Tang Hung-Chuan Pan Chung-Yuh Tzeng Hsi-Kai Tsou 

机构地区：[1]Neurological Institute,Taichung Veterans General Hospital,Taichung 407,Taiwan [2]Functional Neurosurgery Division,Neurological Institute,Taichung Veterans General Hospital,Taichung 407,Taiwan [3]Faculty of Medicine,School of Medicine,National Yang-Ming University,Taipei 112,Taiwan [4]Division of Joint Reconstruction,Department of Orthopedics,Taichung Veterans General Hospital,Taichung 407,Taiwan [5]Department of Medicinal Botanicals and Health Applications,Da-Yeh University,Changhua County 515,Taiwan [6]Department of Rehabilitation,Jen-Teh Junior College of Medicine,Nursing and Management,Miaoli County 356,Taiwan

出　　处：《World Journal of Clinical Cases》2019年第19期3047-3054,共8页世界临床病例杂志

摘　　要：BACKGROUND Cervical disc arthroplasty(CDA)is an alternative treatment to traditional interbody fusion that maintains postoperative cervical spine mobility.However,the CDA postoperative period is impacted by osteolysis,subsidence,metallosis,or heterotopic ossification(HO).We report a case of severe HO in a seronegative spondyloarthritis patient after cervical Bryan disc arthroplasty.CASE SUMMARY A 34-year-old man received hybrid surgery for C4-C5 and C5-C6 arthroplasty with Bryan discs and C6-C7 arthrodesis with polyetheretherketone cage due to traumatic herniation of the intervertebral disc(HIVD).After four years,cervical spine radiographs revealed severe HO around the Bryan discs over the C4-C5 and C5-C6 levels.The magnetic resonance image revealed HIVD over the C3-C4 level with spinal cord compression.Seronegative spondyloarthritis was diagnosed after consultation with a rheumatologist.A second CDA for the adjacent segment disease HIVD with Baguera C disc over the C3-C4 level achieved an excellent outcome.CONCLUSION Minimizing intraoperative tissue trauma and achieving postoperative interbody stability avoid soft tissue traction to prevent HO formation after CDA.BACKGROUND Cervical disc arthroplasty(CDA) is an alternative treatment to traditional interbody fusion that maintains postoperative cervical spine mobility. However,the CDA postoperative period is impacted by osteolysis, subsidence, metallosis,or heterotopic ossification(HO). We report a case of severe HO in a seronegative spondyloarthritis patient after cervical Bryan disc arthroplasty.CASE SUMMARY A 34-year-old man received hybrid surgery for C4-C5 and C5-C6 arthroplasty with Bryan discs and C6-C7 arthrodesis with polyetheretherketone cage due to traumatic herniation of the intervertebral disc(HIVD). After four years, cervical spine radiographs revealed severe HO around the Bryan discs over the C4-C5 and C5-C6 levels. The magnetic resonance image revealed HIVD over the C3-C4 level with spinal cord compression. Seronegative spondyloarthritis was diagnosed after consultation with a rheumatologist. A second CDA for the adjacent segment disease HIVD with Baguera C disc over the C3-C4 level achieved an excellent outcome.CONCLUSION Minimizing intraoperative tissue trauma and achieving postoperative interbody stability avoid soft tissue traction to prevent HO formation after CDA.

关 键 词：SERONEGATIVE SPONDYLOARTHRITIS Disc ARTHROPLASTY HETEROTOPIC OSSIFICATION Case report 

分 类 号：R68[医药卫生—骨科学]