SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2020
Complications of cervical total disc replacement and their associations with heterotopic ossification: a systematic review and meta-analysis.
Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Impact of heterotopic ossification following lumbar total disk replacement: a systematic review.BMC musculoskeletal disorders · 2022Pooled it
- A Comprehensive Review of Spinal Arthroplasty.Neurospine · 2026Review
- Article
- Motion preservation for hyperextension injuries of the cervical spine-an alternative to spondylodesis? A biomechanical cadaver study.Archives of orthopaedic and trauma surgery · 2025Article
- Reoperation Strategy for Failure of Cervical Disc Arthroplasty at Index and Adjacent Levels.Journal of clinical medicine · 2025Review
- Clinical and Radiographic Outcomes of Cervical Disc Replacement Versus Posterior Endoscopic Cervical Decompression: A Matched-Pair Comparison Analysis.Neurospine · 2024Article
- More anterior bone loss in middle vertebra after contiguous two-segment cervical disc arthroplasty.Journal of orthopaedic surgery and research · 2024Article
- The Effect of Preoperative Cervical Spondylosis on Heterotopic Ossification After Cervical Disc Replacement.Global spine journal · 2024Article
- Adjacent segment degeneration after single- and double-level cervical total disc replacement: a cohort with an over 12-year follow-up.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- Catastrophic delayed cervical arthroplasty failure: illustrative case.Journal of neurosurgery. Case lessons · 2022Article
- Letter to the Editor concerning "Complications of cervical total disc replacement and their associations with heterotopic ossification: a systematic review and meta-analysis" by N. Hui, et al. [Eur Spine J; 2020; 29(11):2688-2700].European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- Answer to the Letter to the Editor of Shen YW, et al. concerning "Complications of cervical total disc replacement and their associations with heterotopic ossification: a systematic review and meta-analysis" by N. Hui, et al. [Eur Spine J; 2020; 29(11):2688-2700].European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAlthough cervical total disc replacement (CTDR) is perceived as a safe procedure, no review to date has quantified the complication rates. Of note, heterotopic ossification (HO), one of the complications of CTDR, is hypothesised to cause adjacent segment degeneration (ASDegeneration). This association has not been proven in meta-analysis. Hence, this systematic review and meta-analysis aims to investigate the pooled prevalence of complications following CTDR among studies that concomitantly reported the rate of HO, and the associations between HO and other complications, including ASDegeneration.
methodsLiteratures search was conducted in Embase, MEDLINE, PubMed, and the Cochrane Central Register of Controlled Trials. Complications were stratified into ≥ 1 and < 2 years, ≥ 2 and < 5 years, and ≥ 5 years follow-up. Subgroup and meta-regression analyses were performed.
resultsFifty-three studies were included, composed of 3223 patients in total. The pooled prevalence of post-operative complications following CTDR was low, ranging from 0.8% in vascular adverse events to 4.7% in dysphagia at short-term follow-up. The rate of ASDegeneration was significantly higher at long-term follow-up (pooled prevalence 36.0%, 95% confidence interval [CI] 22.8-49.1%) than that at mid-term follow-up (pooled prevalence 7.3%, 95% CI 2.8-11.8%). Multivariate meta-regression analysis demonstrated that ASDegeneration was independently and inversely correlated with age (p = 0.007) and positively correlated with HO (p = 0.010) at mid-term follow-up. At long-term follow-up, ASDegeneration was still positively correlated with HO (p = 0.011), but not age. Furthermore, dysphagia was inversely associated with HO (p = 0.016), after adjustment for age and length of follow-up.
conclusionIn conclusion, HO is associated with ASDegeneration and dysphagia.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.